When can a doctor charge a cancellation fee for unattended appointments or appointments canceled at short notice?

Whether a cancellation fee can be demanded depends initially on the organization of the appointment allocation system : If the practice is an ordering practice in which the agreed appointment is available solely to the respective patient, it is generally possible to demand a cancellation fee. However, it must be apparent to the patient that the appointment is being kept exclusively for them and is therefore binding. However, if several patients are booked for one appointment in the practice, it is not possible to request a cancellation fee.

It is possible to establish an appointment practice by communicating this to the patient when the appointment is made. For reasons of preserving evidence, we recommend informing the patient of this in writing or text form. However, care must be taken to ensure that the patient's right to terminate the contract at any time (Section 627 BGB) is not inappropriately restricted. This is because the patient must be able to terminate the treatment contract at any time. Whether there is a termination of the treatment contract or (only) a cancellation of an appointment (while maintaining the treatment contract) must be examined for each individual case.

Regulations are often used which require the patient to cancel at least 24 hours or 48 hours before the appointment. The length of the treatment in question can be used as a yardstick for the question of the time limit for cancellation: If it is a simple and shorter treatment, the cancellation period may be correspondingly shorter. With such appointments, it is easier and quicker to compensate for the cancellation by passing the appointment on to another patient. For more complex treatments, the deadline for canceling the appointment may also be longer. This is to take account of the fact that the doctor needs a certain amount of preparation when canceling such complex treatments and that such appointments cannot simply be given to another patient.

The amount of the cancellation fee may not exceed the amount of the fee that would have been incurred if the appointment had been kept. If the doctor is able to treat another patient despite the canceled or unattended appointment, he must allow this to be offset against his cancellation fee.

More details: BGH (III. Civil Senate), judgment of 12.05.2022 - III ZR 78/21