Wiki after hour modifier


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I was asked by one of my doctor, if there was a modifier for after hour
services. I told him no there isn't any only cpt code. Does any know anything?

Thank you all in advance


no modifiers that I'm aware of, just CPT 99050 in addition to your basic service, i.e. 99213 and 99050 are billed together. We get paid just fine for the commercial insurances.... Medicare and Medicaid, no way! :)
Be sure the medical record accurately documents the service to be truly "after hours". It is a code frequently abused. Just because the office/doc is running late does not mean it is accurate to use an after hours code. My interpretation is the patient needs to have been scheduled to be seen "after hours".
you don't have to be scheduled. urgent cares use it after 5 and before 8 every day, which are typically walk ins. i agree that because the doc is running late, i wouldn't charge. the record should state the time to justify the use of the code.
We use 99050 when the Doctor sees a patient after or before office hours. Our docs don't see patients after hours unless it's an urgent situation.

We hold extended office hours on Saturdays for sick patients only and for those we use 99051. Some commercial carriers will not pay 99051 but if the hours are posted you cannot use 99050.

99050 Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, Saturday or Sunday) in addition to basic service.

99051 Services provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service.