Credit Card Surcharge (Pass-Through Processing Fees)
Credit card surcharge is an optional setting that allows your practice to pass credit card processing fees through to patients, rather than absorbing them as a practice expense. When enabled, SigmaMD automatically calculates and applies the fee at the time of payment.
How it works
Who it applies to
Surcharge applies only to credit card payments. Debit card transactions are not subject to surcharge — federal and card network rules prohibit surcharging debit cards.
The rate
The standard rate is 2.99% of the transaction amount, with no per-transaction fee.
States where surcharge is not available
Credit card surcharge is not permitted in the following states:
- Colorado
- Connecticut
- Maine
- Massachusetts
- Oklahoma
If your practice is located in one of these states, the surcharge option will not be available.
What patients pay
When surcharge is enabled and a patient pays by credit card:
| Invoice amount | Surcharge (2.99%) | Patient pays | Clinic receives |
|---|---|---|---|
| $100.00 | $2.99 | $102.99 | $100.00 |
| $50.00 | $1.50 | $51.50 | $50.00 |
When a patient pays by debit card (surcharge not allowed):
| Invoice amount | Processing fee | Patient pays | Clinic receives |
|---|---|---|---|
| $100.00 | $2.40 (absorbed) | $100.00 | $97.60 |
How funds are settled
- With surcharge: Fees are settled per transaction. USPay deposits the full invoice amount directly into your bank account — no end-of-month deductions.
- Without surcharge: USPay deposits the full invoice amount, then debits processing fees (2.4% + $0.15/transaction) from your bank account once a month.
How it appears on invoices
The surcharge is shown as a separate line item labeled "Credit card processing fee" on the patient's invoice. The invoice clearly distinguishes the base charge from the processing fee, so patients can see exactly what they're paying and why.
In your revenue reports, surcharges appear under their own Surcharge category, separate from memberships, charge items, fees, and shipping — making it easy to track.
How patients are notified
When a patient enters a credit card during enrollment or payment in the SigmaMD patient app, an automatic notice is displayed before they complete the transaction:
"Credit card processing fee applies."
The exact fee amount is calculated and shown in the enrollment summary or the invoice.
Enabling surcharge for your practice
Credit card surcharge is configured at the practice level. Contact SigmaMD support to enable or disable this feature for your account. Once enabled, the setting applies to all credit card transactions across your practice.
For help enabling this feature or questions about your specific setup, contact our support team.