@roch, you're right. This is important information for Mayo Clinic patients to know.

As you underlined, not all patient portal messages are subject to billing. To be eligible for billing, the message must be patient-initiated and require a clinical decision that otherwise would have been provided through an in-person or virtual office visit. Patients who can't afford the charges will be referred to financial assistance.

Note: this is referring to the patient portal, called Patient Online Services https://onlineservices.mayoclinic.org/content/staticpatient/showpage/patientonline
Patient Online Services is the patient portal where you can see medical records, contact your care team, see reports and test results, as well as schedule appointments.