Overview
CPT® Code 99050 is used to report services provided in a physician’s office or clinic outside of regular scheduled office hours, including evenings, weekends, or recognized holidays. This code applies when the patient is seen for an unscheduled visit that requires the provider’s professional services beyond normal operating hours.
99050 captures the professional service for time outside regular hours. Any procedures, evaluations, or treatments performed during this visit are billed separately using the appropriate CPT codes.
Key Facts About CPT® 99050
- Service type: Office visit – off-hours/holiday/weekend
- Provider type: Physicians, nurse practitioners, physician assistants, and other qualified healthcare professionals
- Medical services included:
- Professional evaluation and management of a patient outside of normal office hours
- Clinical decision-making and documentation for unscheduled care
- Provision of medically necessary interventions
- Time-based: Not a timed code; billed per service provided outside scheduled hours
- Common clinical indications:
- Urgent care for acute illness or injury
- Post-operative concerns outside office hours
- Unscheduled follow-up for exacerbated chronic conditions
- Emergency consultations during evenings, weekends, or holidays
When to Use CPT® 99050
CPT 99050 is appropriate when:
- The patient is seen in the office outside regular scheduled hours
- Services provided are medically necessary and professionally documented
- The visit is unscheduled and not part of routine office hours
Examples:
- Evening evaluation of a patient with sudden asthma exacerbation
- Weekend post-operative wound check for infection
- Holiday visit for acute laceration or injury requiring immediate attention
- Evening management of uncontrolled hypertension in a returning patient
Documentation Requirements
To properly support CPT 99050 billing, documentation should include:
- Patient identifiers, date, and time of visit
- Reason for the unscheduled or off-hours visit
- Clinical evaluation and interventions provided
- Professional decision-making and follow-up instructions
- Notation that the service occurred outside regular office hours, holidays, or weekends
Comprehensive documentation ensures reimbursement compliance, audit readiness, and accurate patient care tracking.
Reimbursement and Coding Considerations
- CPT 99050 is generally reimbursed in addition to the usual E/M services provided during the off-hours visit
- Only applicable for unscheduled services outside regular office hours
- Not billed when services are part of a pre-arranged appointment during normal hours
- Always verify payer-specific rules for after-hours or holiday visits
How OptiMantra Supports After-Hours Services
OptiMantra’s integrated EMR and practice management platform streamlines documentation, scheduling, and billing for services provided outside normal office hours, including CPT 99050.
With OptiMantra, providers can:
- Track visit timing, patient conditions, and interventions
- Generate claims for unscheduled services
- Integrate after-hours visits into the patient’s longitudinal care plan
- Coordinate follow-up and ongoing management efficiently
By centralizing documentation, billing, and scheduling for off-hours services, OptiMantra ensures accuracy, compliance, and smooth workflows for urgent and unscheduled patient care.
Try OptiMantra for free here!
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