This page is expanded from a column by David Stern, MD, CPC in the Journal of Urgent Care Medicine, May 2007
Q. We have an urgent care center that offers late-night services until midnight, seven days per week. We code with add-on code 99053 for services provided between 10 p.m. and 8 a.m., per the definition of this code. We are not open for 24 hours, but there does not seem to be another code to compensate for late-night services. Is this legit?
A. No. The definition of CPT code 99053 denotes that it can be used for “service(s) provided between 10 p.m. and 8 a.m. at a 24-hour facility, in addition to basic service.” This code should never be used by centers that are not open for 24 hours. Unless your clinic operates on a 24-hour schedule on the day of a patient visit, you should not use 99053 for that visit. Instead, use code 99051 (services rendered during regularly-scheduled evening, weekend and holiday hours). If you choose to see a patient who comes in after your posted closing time, you can bill code 99050 (services rendered after regularly-scheduled hours).
If you do operate a 24-hour urgent care, code 99053 is appropriate. Use 99053 as an add-on code to receive reimbursement for the additional expense incurred by being open all night. |
