Primary Care Coding Alert

Question: What documentation do the special services after-hour codes require?


South Carolina Subscriber

Answer: Signage is the key to documenting that your family physician provided after-hours services and to choosing the correct after-hours code. Practices should make sure to post their office hours.

That way, when a physician provides services after those hours, you can use 99050 (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).

When your office regularly schedules evening, weekend or holiday appointments and you provide services during those times, assign 99051 (Service[s] provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service).

Tip: The time on the chart entry or the appointment schedule will then substantiate that the FP provided after-hours or late-night services. Coverage will still depend on the insurer.