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Regulatory Updates
AFTER HOURS NOW WILL BE PAID

After hours or weekend care Current Procedural Terminology (CPT®) codes represent services provided when an individual physician or other health care professional is required to render the services outside of regular posted office hours to treat a patient's urgent illness or condition. This policy outlines when after hours or weekend care codes are considered for separate reimbursement. 

CPT Code 99050 and 99051

Although CMS considers CPT codes 99050 and 99051 to be bundled into the payment for other services provided on the same day, Oxford will provide additional compensation to participating primary care providers.

Oxford will reimburse CPT codes 99050 and 99051 when reported with basic services in one of the following CMS non-facility place of service (POS) designations only:

POS Code Description

  • 03 School
  • 05 Indian health service free-standing facility
  • 07 Tribal 638 free-standing facility
  • 11 Office
  • 49 Independent clinic
  • 50 Federally qualified health center
  • 71 State or local public health clinic
  • 72 Rural health clinic

Oxford will reimburse to the following participating primary care providers

  • Adolescent medicine, pediatric-adolescent, pediatrics
  • Family nurse practitioner, nurse practitioner, pediatric nurse practitioner, advanced registered nurse practitioner
  • Family practice
  • General practice
  • Geriatric medicine
  • Gynecology, obstetrics & gynecology, obstetrics
  • Internal medicine
  • Certified nurse midwife

 

Learn more here.

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October 2018