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2025 CPT code 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.

Report 99050 in addition to the appropriate E/M service code. Do not report this code if the office is simply staying open late to accommodate patients already waiting at closing time.

Modifier 51 is not applicable to this code.

Medical necessity must be clearly demonstrated for the after-hours or off-day service.The documentation should explain why the service could not wait until regular office hours or a typical business day.

The physician sees a patient outside of normally scheduled office hours or on a day the office is usually closed. The physician is responsible for documenting the medical necessity of the after-hours or unusual-day service.

In simple words: This code covers the extra service provided by the doctor when they see you outside of their regular office hours or on a day their office is usually closed, like a weekend or holiday.It's billed on top of the regular charge for the visit itself.

This code is used for services rendered in the office outside of normal office hours or on days when the office is typically closed. It is reported in addition to the primary service provided.Examples include a patient seen on a holiday, weekend, or after hours due to an urgent need. It is important to note that if the office remains open late to accommodate waiting patients from regular hours, this code may not be applicable.

Example 1: A patient experiences a sudden onset of severe migraine late on a Saturday evening.The physician opens their office specifically to see this patient. The appropriate E/M code for the migraine visit and 99050 are reported., A patient scheduled for a routine follow-up appointment on a Wednesday afternoon develops a high fever and cough the night before.The physician agrees to see the patient early Tuesday morning before regular office hours begin. The office was closed before the physician arrived. Along with the appropriate E/M code, 99050 is reported., A physician makes a house call on Christmas Day to evaluate a frail elderly patient who has developed a new onset of shortness of breath.The physician bills 99050 along with the house call code.

Documentation must support the medical necessity of the service provided outside of regular office hours or on a day when the office is typically closed. The reason for the visit and the services provided should be clearly documented.

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