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I work for an urgent care center. We bill S9088 on our claims for the urgent care code. Can we also bill a 99051 for the weekends? I don't see anything saying we can't, but I wanted some other opinions. Thanks
You can bill it, but Medicare/Medicaid definitely won't pay for it, as it's considered bundled. Many insurance companies won't pay for it either, especially if they base their payments/fee schedules on Medicare's. I would check with some of your contracted insurance companies to see if they allow it or consider it bundled.
what is the overall reimbursement for S9088? I realize Medicare won't pay but do other carriers? What place of service is used? Do your patients experience higher or lower copays with this code and POS?