Health care symbol and dollar sign (Graphic: Chris Nicholls)

At least eight health systems have said they will bill for some patient portal services such as Epic's MyChart, signaling a possible new expense for consumers and sponsors of health plans.

The development drew national attention in November, when Cleveland Clinic began charging for certain types of messages, primarily those that involved clinical assessments or medical history reviews that take more than five minutes. Other MyChart services will remain free, according to media reports, including appointment scheduling, prescription refills, as well as most questions about appointments and recent visits.

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