Questions for Dr. Stern
About Your Urgent Care Center
17. My office has started to provide urgent care. Should our urgent care services be reimbursed at a higher price than our family practice services? Is there a different "fee schedule"?
Here is the scoop on your situation:
- Some payors will pay more for urgent care services, but you will almost certainly need to operate under a separate TIN. You may need to negotiate to get higher rates.
- Many payors will not pay more for urgent care (some pay less).
- Medicare will not pay more.
- 99051: You may use this code for evening, weekend, and holiday reimbursement. Many payors will not pay.
- S9088: You may add this code to existing codes for services that you provide in an urgent care center. Some payors will pay an additional amount.
- Urgent Care Co-Pay: Make sure that if you bill as an urgent care center, you collect the co-pay for urgent care as listed on patients' insurance cards.
