With surcharge pricing, your patients pay a 2.75% processing fee on credit card transactions — so your practice keeps 100% of the payment amount. This article explains how to turn on surcharge pricing and how it works across your payment collection methods.
Surcharge pricing is only available in some US locations due to local legal and regulatory requirements. Practices in Connecticut, Massachusetts, and Puerto Rico are not eligible.
Surcharge pricing does not require Ledger Sync — all NexHealth Payments customers in available jurisdictions can use it.
What surcharging applies to
Surcharge pricing applies to credit card transactions only. Your practice pays standard processing rates for debit cards and other payment methods.
Insurance payments are not eligible for surcharging. Insurance payments are subject to card-not-present fees regardless of whether surcharge pricing is enabled on your account.
Turn on surcharge pricing
Once enabled, all eligible credit card collections will automatically include surcharging.
1. Go to Gear icon → Settings → Processing fees.
You can find the gear icon in the upper right, and Processing fees at the bottom of the left sidebar.
2. Toggle on Surcharge pricing.
A teal switch means surcharge pricing is on.
3. Select I understand to acknowledge the legal and regulatory requirements.
When you turn on surcharge pricing, you will need to acknowledge that you understand the legal and regulatory requirements. These vary based on location.
Signage must be displayed near the point of sale and at the point of entry to the business. NexHealth provides a printable pricing notice PDF automatically tailored to your jurisdiction (for example, Colorado has a unique disclaimer).
To copy this setting to multiple locations at once, click Copy under Surcharge pricing, then select the locations.
How surcharging works at checkout
When surcharge pricing is enabled, NexHealth will:
Automatically detect whether the payment method is eligible for surcharging
Notify the patient about the surcharge before they complete the transaction
Append the surcharge to eligible credit card transactions and reflect it in receipts and Payments reports
Send a payment request
NexHealth notifies the patient about surcharge pricing when they enter a credit card.
Charge a credit card on file
You'll be reminded to verbally notify the patient about surcharge pricing before charging.
Use a terminal
The terminal notifies the patient about surcharge pricing before they swipe or tap.
In New York and Maine, to comply with state-specific surcharge disclosure regulations, instead of showing the procedure cost and surcharge separately, NexHealth displays the combined amount in payment requests. The patient sees a disclaimer indicating they'll receive a discount for using a debit card.
Receipts and refunds
Receipts show the surcharge as a separate line item
The patient receives a receipt to their email when the transaction is complete. You can also click View receipt within NexHealth. The receipt displays the surcharge as a separate line item, in line with legal requirements.
Refunds automatically include proportionate surcharge amounts
When issuing a refund, enter the pre-fees amount (the cost of care, not including the surcharge). NexHealth automatically calculates the proportionate surcharge to refund.
For example: a $100 payment with a $2.75 surcharge totals $102.75.
To refund the full payment, enter $100 — NexHealth refunds $102.75.
To make a partial refund of $40 of care, enter $40 — NexHealth refunds $41.10.
If the patient did not pay with a credit card, the surcharge refund field will not appear.