Questions for Dr. Stern
About Your Urgent Care Center
67. Our corporation is building a new business/office complex with plans to include a Urgent Care. We currently provide services in the areas of Hospice, Homecare, Home Health and Mental Health. My question is if the agency owners are not a licensed physician, what steps will we need to take to get a license to operate in North Carolina and is this possible?
Thanks for the question. Where did your doctor get this information?
To my knowledge, nothing has changed; and Medicare does not reimburse for 99051. Unless you get information to the contrary from an official Medicare source, I would recommend that you should not bill this code to Medicare.
You may reference this at: http://www.umd.nycpic.com/07Bstatus.html
You doctor may have received this information (about your Indiana MediCAID, not Medicare) in a recent publication of the Indiana State Medical Society (http://www.ismanet.org/resources/mm_coalition/1-18-08/index.htm), where they state:
Medicaid reimburses for after hours: The ISMA staff reminds you of the following Medicaid billing code pertaining to evening, weekend and holiday hours.
“Procedure code 99051 - Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service, providers may bill a maximum of one unit per patient per day. Evening hours are defined as routinely scheduled after 5 p.m. in the prevailing time zone. Providers may only bill for the following holidays, which represent days when physician offices are generally closed for the day: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. When billing for 99051, please document in the medical chart the time, date, or holiday, as applicable. All other billing requirements will remain unchanged.” Please let me know if you get any information to the contrary.
