Immediate Care Business: “Urgent Care Center Coding and Reimbursement”

Operators of urgent care centers are familiar with the notion that they can’t code using emergency room E/M codes (99281-99285) as they do not meet the CPT definition of emergency room. An emergency room must be hospital- based and open around the clock. These requirements are not “either/or;” they are “and,” to indicate both conditions must be met. This means urgent care centers should use the new and established outpatient codes 99201-99215 for reporting encounters.

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