Ambulatory Care

Ambulatory care is medical care you receive without being admitted to a hospital; you walk in, get treated, and walk out the same day. It includes a broad range of services: doctor's office visits, outpatient surgery, diagnostic tests, physical therapy, urgent care visits, and same-day procedures at outpatient clinics or surgery centers.

This is the category most of your health care falls into. The vast majority of doctor visits, lab tests, imaging, minor surgeries, and follow-up appointments are ambulatory care. You only become an inpatient when your condition requires formal hospital admission and usually an overnight stay.

ACA-compliant plans cover ambulatory patient services as one of the ten essential health benefits. Your cost-sharing for ambulatory care depends on the specific service and your plan: preventive visits are $0 when in-network, primary care visits usually have a copay, and outpatient procedures or surgeries typically involve coinsurance after your deductible.

One important nuance: some hospitals have outpatient departments where you receive ambulatory care, but the facility charges can be higher than at a standalone doctor's office or surgery center. The same procedure at a hospital outpatient department might cost significantly more than at an independent outpatient surgery center, and your share of the cost scales accordingly.

When you can, compare facility costs for planned outpatient procedures. Your insurer may have a cost estimator tool, or you can request a Good Faith Estimate under the No Surprises Act.