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MedicaidBilling CodesMedium impact

Billing for Physician Services After Hours and Holiday Hours

Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Dec 1, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Physicians can now bill additional procedure codes 99050 (for after-hours services outside regular office hours) and 99051 (for services during scheduled evening, weekend, or holiday hours) in addition to the primary service code. This applies to services provided on specified holidays or outside the physician's publicly known office hours.

Action Required

Action needed
Immediately: Billing team must update billing system to allow adding CPT codes 99050 or 99051 as additional charges when services are provided after hours or on holidays (Memorial Day, Independence Day, Labor Day, Thanksgiving, Christmas, New Year's Day). Train staff to identify qualifying scenarios and ensure proper code application alongside primary service codes.

Affected Billing Codes

99050
99051