The care was routine. A 30-year-old male suffered from back and shoulder pain following a car accident. He was treated at Modesto Hospital in California. In less than three hours, he was home.

It was a remarkable bill. Sutter Health Memorial Medical Center charged $44,914 and an $8,928 “trauma alarm” fee. This was billed to summon the hospital’s top surgeons, often associated with the most severely wounded patients.

This case is found in the records of an 2017 trial. It is rare to see a courtroom challenge to something that billing consultants claim is becoming more common at U.S. hospital.

Hospitals charge huge trauma alert fees that can be applied to injuries so minor they are not admitted. This is tens of thousands of times per year.

According to an analysis of state data by Etienne Pracht (an economist at the University of South Florida), hospitals in Florida charged these fees more than 13,000 time even though patients went home that day. These cases accounted for more that 25% of state’s activations for the trauma team in 2018 and more than twice the number of similar cases in 2014. According to an all-payer database, Florida’s Agency for Health Care Administration kept a list of hospital claims.

False alarms are not uncommon, but hospitals often charge for very little or no treatment. Consultants say that this is because they see the alerts more as a money spigot than a tool to aid in an emergency.

“Some hospitals use it as a revenue generator,” Tami rockholt, a registered nursing assistant and medical claims consultant, stated in an interview. She was an expert witness in Sutter Health’s car-accident trial. She said that such cases are “way more common” than they were a few years back.

Hospitals may charge trauma activation fees if a squad of nurses and doctors arrives to treat a trauma patient. It is believed that life-threatening injuries require immediate attention. Hospitals can charge trauma activation fees if a squad of doctors and nurses arrives at a designated trauma center to help pay for the costs of having a team available.

These fees can be more than $50,000 per patient and are charged on top of the hospital charges for emergency medical care.

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Pat Palmer, cofounder of Beacon Healthcare Costs Illuminated which analyses thousands of bills for patients and insurers, said that “we do see quite some non-appropriate trauma costs — more than you would see five years ago.” She said that she recently saw a trauma activation charge where the patient walked into an ER and walked out shortly afterwards.

According to data, the percentage of Florida trauma activation cases that did not require admission increased from 22% in 2012 and 27% last year. Broward Health Medical Centre had 1,285 trauma activation patients in 2019, almost equal to those that resulted in admissions.