Saturday & Holiday Coding (99051)

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The AAP has a straightforward summary detailing how pediatric practices should be billing 99051 for every patient seen on Saturday, Sunday, and Holidays.  The full details can be found here.

 

99051 Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service

  • Used when patients are seen when the practice has regularly scheduled expanded evening hours or regularly scheduled weekend/holiday hours
  • Can be reported in addition to sick/urgent visits, but also for visits addressing chronic medical conditions and preventive medicine services
  • Evenings and holidays are not clearly defined by CPT.
  • Do not report 99051 when:
    • The physician/QHP is running late and sees a patient after regularly posted office hours. 
Picture of Paul Vanchiere, MBA

Paul Vanchiere, MBA

For over 15 years, Paul has dedicated himself exclusively to addressing the financial management, strategic planning, and succession planning needs of pediatric practices. His background includes working for a physician-owned health network and participating in physician practice acquisitions for Texas's largest not-for-profit hospital network, giving him a distinctive insight into the healthcare sector. Paul is adept at conducting comprehensive financial analysis, physician compensation issues, and managed care contract negotiations. He established the Pediatric Management Institute to offer a wide range of services tailored to pediatric practices of all sizes and stages of development, with a focus on financial and operational challenges. Additionally, Paul is actively involved in advocacy efforts to ensure healthcare access and educational opportunities for children with special needs.

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