Practice Management Alert

Question: Our medical office is open from 8 a.m. to 6 p.m. Monday through Friday, and from 8 a.m. until noon on Saturday. Last Saturday at 4 p.m., the physician met an established patient at the hospital and provided a level-three evaluation and management service. Is there any way to account for after-hours services a physician provides?


Georgia Subscriber

Answer: There is an after-hours code in CPT, but you-ll likely have a devil of a time getting any payer to recognize it.

When your physician provides after-hours services, you can report 99050 (Service[s] provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed [e.g., holidays, Saturday or Sunday], in addition to basic service).

Caveat: Medicare carriers will not recognize 99050. With private carriers, there is only one way they will accept 99050: It must be written into your contract with the payer. On the claim, you should only report 99213 (Office or other outpatient visit for the evaluation and management of an established  patient, which requires at least two of these three key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making of low complexity) for the service.