She talked about depression at a checkup — and got billed for two visits.

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She talked about depression at a checkup — and got billed for two visits.
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Completing a routine depression screening questionnaire during an annual checkup is cost-free under federal law. But, as one woman discovered, answering a doctor's follow-up questions might not be.

Christine Rogers of Wake Forest, North Carolina, was asked to complete a mental health questionnaire as part of her annual physical. A brief conversation with her doctor landed her with a charge for a separate consultation.

But there is a catch: Not all care that may be provided during a wellness visit counts as no-cost preventive care under federal guidelines. If a health issue arises during a checkup that prompts discussion or treatment — say, an unusual mole or heart palpitations — that consult can be billed separately, and the patient may owe a copayment or deductible charge for that part of the visit.

Rogers requested an itemized bill from her doctor's practice, which is part of WakeMed Physician Practices. It showed a charge for the wellness visit , as well as a separate charge for a 20- to 29-minute office visit. Earlier, Rogers said, she had discussed the initial bill with the office manager at her doctor's office, who told her the separate charge, roughly $67, was for discussing her questionnaire results with her doctor.

Beyond the confusion of being charged for what she thought would be free preventive care, Rogers wondered how the bill was calculated: Her conversation with her doctor about depression did not last that long, she said. "If you have a condition like depression, not only does it affect mental health, but it can have significant impact on your medical health overall," said Stephen Gillaspy, senior director for health and health care financing at the American Psychological Association.

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