Pediatricians often provide care on an urgent or unscheduled basis in the office or other outpatient setting or in other settings (eg, emergency department [ED]) at the request of the patient. These services may reduce unnecessary ED visits and contribute to better continuity of care. However, practice expenses and physician workloads also increase. Recognizing this, Current Procedural Terminology® includes codes for services provided under certain circumstances (eg, on an emergency basis, outside of the typical Monday–Friday office hours). Some payers also recognize the value of physicians providing urgent or after-hours visits, but it is important to learn what plans in your area include in their payment policies.

For instance, some commercial plans and Medicaid managed care administrators allow payment for after-hours and weekend care provided outside of regular office hours to treat a patient’s urgent illness or condition. The service is reported with code 99050 in addition to the...

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