Eli's Rehab Report
After Hours Codes
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Question: We maintain an after hours clinic for our rehabilitation patients experiencing pain. We dont accept appointments. Can we bill after hours codes for the patients who present past 5 p.m.?
Texas Subscriber
Answer: You can only bill the after hours codes (99050-99054) if the patient presents after your practice normally closes. For instance, if your practice (or clinic) is always open until 9 p.m., you cant bill the after hours codes for a patient who comes in at 8:30.
If you intend to use an after hours code, note that it is an add-on code that should be listed after your normal E/M code. For instance, if you normally close at 5 p.m., but you see a patient for a level-two office visit at 6, you can bill 99212 along with 99050.
The code 99052 applies to services provided between 10 p.m. and 8 a.m., while 99054 should be billed on Sundays and holidays. Payment for after hours codes is carrier-specific, and not all will reimburse for them. However, it is correct coding to use these codes because they allow your claims to be coded to the highest level
of specificity.
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