tci Medicare Compliance & Reimbursement - 2015 Issue 21

Reader Question: Don't Count on Pay for 99051

Question: We are looking to hire a pediatrician, but in the meantime our schedule is overwhelmed, so we decided to open our doors for several Saturdays and weekday evenings until further notice. Should we charge after-hours code 99050 at these appointments? Answer: No. You should instead use 99051 (Service[s] provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service), which is for services occurring on evenings and weekends during scheduled hours. In contrast, code 99050 (Services provided in the office at times other than regularly scheduled office hours, or days when...

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