First, a health care professional does not have to provide an interpreter if doing so would result in a "fundamental alteration" of the professional's services. However, this exception will probably never apply because a sign language interpreter would not result in a fundamental alteration of a health care professional's services.
Second, a health care professional does not have to provide an interpreter if doing so would result in an "undue burden, i.e., significant difficulty or expense." However, in determining whether providing an interpreter would result in an "undue burden," the professional must consider: (1) the cost of the interpreter and (2) the professional's overall financial resources. The professional may not refuse to provide an interpreter because the cost of the interpreter exceeds the professional's fee for the office visit. Providing an interpreter will hardly ever result in an "undue burden" on a doctor because the cost of an interpreter will likely be insignificant when compared to the doctor's overall financial resources. However, providing an interpreter may result in an "undue burden" if the doctor has a very large number of patients who are deaf, and most of the doctor's patients are covered by a government health care program that pays minimum rates.