Posts

After Hours Codes Update (99050, 99051, 99058)

In days of yore, I wrote about the pediatric usage of the 9905X CPT codes, often known as the “after hours” codes.  In fact, I think my explanation here about how they should be used is still good (corrections, suggestions welcomed).  Just before the holiday break, a request for updated data came through SOAPM – …

Payer Shenanigans and HITECH Loophole

This is a long one, but worth reading.  The names have been changed to protect both the innocent and the guilty. The story begins with a clever pediatric practice who decides that since Insurance Company A (we’ll call them Cygnus to keep it short) does not want to pay for the 99051 code, it will …

Extended Office Hours

I have written here extensively about the various “scheduling based codes” and their usage – or lack of usage – among pediatricians, but have made the mistaken assumption that most of you reading here actually have extended office hours. It is this pediatric practice management consultant’s position that if you are not offerring office hours …

99051 Real Life Example

A faithful reader sent the following to me and allowed me to post it, as I think the information is valuable to you all.  I have a lot to say about it at the end. Chip, I would like to share our preliminary results for CPT 99051. After reading your post about this code, we …

More 99050, 99051, 99053, 99058 Madness

As promised, I will show you the money. Click on the picture below (or here) for a better view of the average reimbursement for these scheduling based codes. What we see are fairly consistent reimbursement for the codes with the variation being explained by the additional payers being added on all the time (look at …

After-Hours Codes And Other Scheduling-Based Codes (99050, 99051, 99053, 99058)

In 2008, the CPT definition of the classic “after-hours” codes changed. Gone is all the rigmarole about whether your hours are “posted” or whether your patients know you are open on weekends and all the other commentary that used to convince our clients not to use these important codes. The bottom line: if you see …