Reader Question:
Medicare Won't Recognize 'After Hours'
Published on Fri Jan 02, 2004
Question: A Medicare patient knocked on the door on a Friday when the office was closed. He was concerned that some medication the physician prescribed was having an adverse effect. The physician agreed to see the patient and performed an E/M service. May we report 99050 in addition to an office visit?
South Carolina Subscriber Answer: Code 99050 (Services requested after posted office hours in addition to basic service) is listed as a "Status B" code in the Medicare fee schedule. This means that CMS has not assigned any relative value units to this service, and it is always bundled. Therefore, Medicare will not pay you for use of this code. Because Medicare is the payer in the scenario described, you may bill only the E/M code.
But some commercial insurance companies will reimburse for 99050. Physician practices will often negotiate this code as part of their fee schedule with commercial payers.
