How To Use CPT Code 99050

CPT 99050 describes the provision of services in a healthcare provider’s office outside of regularly scheduled office hours. This article will cover the description, official definition, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99050?

CPT 99050 can be used to describe the services provided by a healthcare provider in their office during times when the office would typically be closed. This code is used when the provider sees a patient outside of their normal office hours, such as on holidays, Saturdays, Sundays, or after regular closing hours.

2. Official Description

The official description of CPT code 99050 is: ‘Services 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.’

3. Procedure

1. The healthcare provider sees a patient in their office outside of normal office hours.
2. This can occur on holidays, Saturdays, Sundays, or after regular closing hours.
3. The services provided during this time are in addition to the basic service provided by the healthcare provider.

4. Qualifying circumstances

CPT 99050 is applicable when a healthcare provider renders services to a patient in their office at a time when the office would otherwise be closed. This code can be used for both scheduled and unscheduled patients who require services outside of regular office hours.

5. When to use CPT code 99050

CPT code 99050 should be used when a healthcare provider provides services in their office outside of regularly scheduled office hours. This code is appropriate for situations where the provider sees a patient on holidays, Saturdays, Sundays, or after regular closing hours. It is important to note that CPT code 99050 should be reported in addition to the appropriate evaluation and management (E/M) code that describes the services rendered.

6. Documentation requirements

To support a claim for CPT 99050, the healthcare provider must document the following information:

• Date and time of the service provided outside of regular office hours
• Reason for the visit during non-standard office hours
• Details of the services rendered during this time
• Any additional notes or relevant information related to the visit

7. Billing guidelines

When billing for CPT 99050, it is important to ensure that the services were provided in the office outside of regularly scheduled office hours. This code should be reported in addition to the appropriate E/M code that describes the services rendered. It is also important to note that some payers may not reimburse for CPT 99050 if the provider’s office hours were extended after normal closing hours to accommodate waiting patients or if the provider stayed after hours to accommodate a scheduled patient who was running late.

8. Historical information

CPT 99050 was added to the Current Procedural Terminology system on January 1, 1990. There have been a few changes to the code since its addition, including updates in 2004 and 2006.

9. Examples

1. A healthcare provider sees a patient in their office on a Sunday to address an urgent medical issue.
2. A patient requires immediate attention and visits the provider’s office on a holiday for treatment.
3. A provider stays after regular office hours to accommodate a scheduled patient who is running late.
4. A provider extends their office hours on Saturdays to accommodate patients who are unable to come during the week.
5. A patient requires a follow-up visit and is seen by the provider after regular office hours to ensure continuity of care.
6. A provider opens their office on a day when it is normally closed to provide services to patients with urgent needs.
7. A patient requires a same-day appointment and is seen by the provider after regular office hours.
8. A provider offers extended evening hours to accommodate patients who work during the day.
9. A patient requires a procedure and is scheduled for an appointment on a Sunday.
10. A provider offers weekend hours to provide services to patients who are unable to come during the week.