Wiki out of office visits

[Loreybarnes29]

Hi guys!

Our provider (family practitioner) routinely gets called into see his patients at skilled nursing facilities outside of our regular office hours. So far, we have only ever billed 9933x depending on the level of care respectively. I was wondering is it possible to bill 99050 in addition to the E&M code?

Any literature on this would be helpful, but I am looking mainly for Medicare/Medicaid guidelines, as most of these patients have those plans.

Thanks in advance!!

 

[CodingKing]

I'm not sure about Medicaid but Medicare will not pay for these codes and bundles into whatever services took place outside of office hours. Technically since you are seeing the patient in a a facility place of service i'm not sure you could even use the code if it was reimbursable

The Centers for Medicare and Medicaid Services (CMS) considers
reimbursement for CPT codes 99050, 99051, 99053, 99056, 99058 and 99060 to be bundled into payment for other services not specified. These codes have a
Status Indicator of ?B? in the National Physician Fee Schedule (NPFS).

Status Indicator B ? Bundled code. Payment for covered services is always
bundled into payment for other services not specified.