Billable Services

Effective: September 1, 2019

Health Service Programs

Health Service Eligibility Program

  • $325.00 per term 
  • Subject to same fee for service schedule as full time registered students paying the Health Access Fee.

Health Service Spouse and Domestic Partner Primary Care Program

  • $615.00 per term
  • Must meet Dartmouth’s insurance requirements.

Office Visits & Physicals

  • Office visit (Registered) - $0
  • Office visit (Leave term and Part Time students) -  $100.00
  • Athletic physical - $100.00
  • DOT physicals - $115.00

Note: Patients will be responsible for any lab or x-ray fees associated with a physical.

Immunizations

  • Chicken Pox (Varivax/Varicella) - $183.00  
  • Hepatitis A (Havrix) - $77.00  
  • Hepatitis B (Engerix, 3 doses) - $58.00  
  • Hepatitis B (Heplisav-B, 2 doses) - $130.00
  • HPV (Gardasil 9) - $290.00
  • Japanese Encephalitis - $399.00  
  • Measles/Mumps/Rubella (MMR) - $101.00  
  • Meningococcal (Bexsero) - $183.00 
  • Meningococcal (Menactra) - $147.00 
  • Pneumonia (Pneumococcal) - $134.00  
  • Polio (Poliovax) - $41.00 
  • PPD (Tuberculosis) - $20.00   
  • Rabies (Rabies) - $395.00  
  • Tetanus Diphtheria (Tetanus Diphtheria) - $38.00
  • Tetanus Diphtheria & Pertussis (Tetanus Diphtheria & Pertussis) - $46.00  
  • Typhoid (Typhim) - $128.00  
  • Yellow Fever is currently unavailable

Immunization fees are per dose and some require more than one dose. 

Please visit the CDC website for more information on the national Yellow Fever vaccine shortage.

Inpatient Admissions

Most admissions to the Inpatient Nursing Department are at no cost to the student.  This would include medical, post-surgical and mental health concerns.

Billable admissions would include:

  • Admissions for intoxication - $464.00
  • Admissions requiring IV fluids for the first 24 hours - $464.00 
  • Admissions requiring IV fluids after the first 24 hours - $1,153.00 per day

Please Be Aware: 

  • Patients will be responsible for lab, x-ray, IV fluids and medication fees associated with an inpatient admission.
  • Billable admissions can be submitted to your insurance for reimbursement.  The Dartmouth Student Group Health Plan (DSGHP) reimburses 100%.

 

Labs / Testing

Any lab that is not paid for by the Dartmouth College Health Service (Dick's House) will be billed directly to the patient by the Dartmouth-Hitchcock Medical Center who processes the specimens.

Lab Billing Awareness

Miscellaneous Services

  • Cane Deposit - $22.00  ($17.00 will be credited when item returned)
  • Crutch Deposit - $29.00  ($24.00 will be credited when item returned)
  • Copy Of Medical Record - $15.00 per copy
  • Copy Of X-Ray - $12.00 per copy

Birth Control

  • IUD (Paragard) - $1,055.00
  • IUD (Mirena) - $1,231.00
  • IUD (Kyleena) - $1,230.00
  • IUD (Skyla) - $1,024.00
  • IUD (Insertion Only) - $508.00
    • IUD purchased through prescription plan
  • Etonogestrel Implant (Nexplanon) - $1,335.00
  • Diaphragm - $92.00

Form Completions

  • Signature only - $0
  • Moderate complexity - $20.00 per form
  • Complex - $50.00 per form

Making a Payment

Payment for billable services can be made with cash, check, credit card or posted to the student's tuition account. Charges posted to the student's tuition account do not state the service or treatment provided as that information is confidential and cannot be released without the patient's written permission.

We are unable to submit claims to insurance companies; however, upon written request of the patient, an invoice will be provided which may be submitted to his/her health plan for reimbursement -- please send a request to Patient Accounts.