How To Use CPT Code 99056

CPT 99056 describes the additional services provided by a healthcare provider outside of their office at the request of the patient. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99056?

CPT 99056 can be used to describe the services provided by a healthcare provider at a location outside of their office, as requested by the patient. This code is used when the provider accommodates the needs of the patient by seeing them outside of their usual office setting.

2. Official Description

The official description of CPT code 99056 is: ‘Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service.’

3. Procedure

1. The healthcare provider receives a request from the patient to be seen at a location outside of their office.
2. The provider arranges a suitable time and place for the appointment, taking into consideration the patient’s needs and preferences.
3. The provider travels to the designated location and meets with the patient to provide the requested services.
4. The services provided may include examinations, consultations, treatments, or any other necessary medical interventions.
5. The provider ensures that the patient’s needs are met and that the services provided are in addition to the basic services offered in their office.
6. After the appointment, the provider documents the details of the visit and any services rendered.

4. Qualifying circumstances

Patients who request to be seen by a healthcare provider at a location outside of their office may qualify for CPT 99056. This code is used when the provider accommodates the patient’s request and provides additional services in addition to the basic services offered in their office. It is important to note that the patient must specifically request to be seen outside of the provider’s office for this code to be applicable.

5. When to use CPT code 99056

CPT code 99056 should be used when a patient requests to be seen by a healthcare provider at a location outside of their office and the provider provides additional services in addition to the basic services offered in their office. This code should not be used if the services provided are the same as those offered in the provider’s office without any additional interventions or accommodations.

6. Documentation requirements

To support a claim for CPT 99056, the healthcare provider must document the following information:

• The patient’s request to be seen at a location outside of the provider’s office
• The specific services provided during the visit
• The date, start and end time of the appointment
• Any additional interventions or accommodations made for the patient
• The provider’s signature to verify the accuracy of the documentation

7. Billing guidelines

When billing for CPT 99056, ensure that the services provided are in addition to the basic services offered in the provider’s office. This code should be reported alongside the appropriate evaluation and management (E/M) code that describes the services rendered. It is important to check the guidelines of the payer, as reimbursement for CPT 99056 may vary. However, including this code in the claim can help with tracking purposes and ensure a complete and accurate submission.

8. Historical information

CPT 99056 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A physician conducting a house call to provide medical services to a bedridden patient.
2. A dentist traveling to a nursing home to perform dental procedures for elderly residents.
3. A physical therapist providing rehabilitation services at a patient’s workplace to aid in their return to work.
4. A psychiatrist conducting a therapy session at a patient’s home to accommodate their specific needs.
5. A chiropractor providing adjustments and treatments at a patient’s gym to assist with their athletic performance.
6. A dermatologist conducting a skin examination and providing treatments at a patient’s place of work.
7. A podiatrist visiting a patient’s home to provide foot care services for individuals with mobility issues.
8. An optometrist conducting eye exams and providing prescriptions at a patient’s retirement community.
9. A speech therapist providing speech therapy sessions at a child’s school to support their communication development.
10. A nutritionist conducting dietary consultations at a patient’s grocery store to assist with healthy food choices.