While facing the daunting tasks of increasing patient access and reducing wait time, practices must explore whether they can offset the extra expense of expanding hours with additional revenue. In some circumstances, higher reimbursement for after-hours care is possible, according to a post from Physicians Practice.
Although Medicare and payers who strictly follow CMS guidelines will not pay more for after-hours care, practices may be able to negotiate additional reimbursement with private payers as part of their contractual agreements, the author noted.
The key to making the deal is to prove that you're saving the payer money by treating patients at your office instead of sending them to the emergency department, such as by compiling a report comparing the costs of your after-hours services to similar care provided in the ED.
If your practice sees patients outside of normal business hours, familiarize yourself with CPT codes:99050, 99051 and 99053 and their descriptions.
To learn more:
- see the post from Physicians Practice