Wiki Consult After Hours Charge

[ccamacho2015]

My physician was told by his friend that if he does a consult after hours at the hospital there was an add on code he could charge. Or if the consult interrupted his day the could bill an add on code and he would be paid more. Any idea what the code is? Do the carriers pay it?

HelP!!

 

[mitchellde]

Yes there are additional codes but they are for services provided in the office setting. they range from 99050 thru 99060 and they are codes that are used inaddition to other services and are not restricted to E&M codes. Some payers will pay them and others will not.

 

[csperoni]

Supplemental services and supplies section

There are a few codes to indicate services were provided at specific times or outside hours. These codes are all IN ADDITION to the E&M code.
99050 - services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed
99051 - services provided in the office during regularly scheduled evening, weekend, or holiday office hours
99053 - services provided between 10pm and 8am at 24 facility
99056 - services typically provided in the office, provided out of the office at request of patient
99058 - services provided on an emergency basis in the office, which disrupts other scheduled office services
99060 - services provided on an emergency basis, out of the office, which disrupts other scheduled office services.

DISCLAIMER: these codes do not have RVU values. Medicare will NEVER pay for them. Most other carriers will not pay (it could depend on the carrier, or on your contract). Just because a code exists, does not mean it will be covered or paid. I recommend trying it out for each carrier & send an appeal when it's denied. If you determine these are codes you could use often, and will get paid additional, you should absolutely do so. If you determine it is denied 99.9% of the time, and appeal is never overturned, you may decide it is not worth the time & effort.