SEP 10, 2019
After Hours Exam
Question: Our physicians are seeing more patients after hours, due to patient emergencies, such as foreign bodies. Are we able to charge the payer or patient additional dollars for this service?
Answer: If you are billing Medicare, you can only submit for the exam service and any testing or surgeries that are medically necessary. Some commercial payers may allow a separate CPT code such as 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. Best to verify with your payer prior to billing.
Learn more about unusual office exams in the Ophthalmic Coding Coach.