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When a service is rendered, these settings determine if the service was performed during Non-Crisis Hours (After Hours) or during regular business hours. If the service was rendered during After Hours and the procedure is flagged with the After Hours Add On, the After Hours Add On CPT code (99051) will be automatically added to the claim during the My Billing process. Refer to the example below and the following steps to set up the After Hours Time Limits in order for After Hours Add On to be billed correctly.
NOTE: If a service is considered to be a Crisis service, the CPT code will be a Crisis CPT Code. The example below is for regular business hours of 8am to 4pm.
- Go to Setup 🡪 Billing/Program Defaults 🡪 After Hours/Time Limits Tab.
- Program- Select the Program to which you want to apply After Hours Time Limits.
- Use Hours- Select to define Crisis Hours and Non-Crisis Hours (After Hours) for the Program.
NOTE: The Crisis Hours and Non-Crisis Hours must match for the After Hours Add On to be billed correctly.
- Use Total Service Time Limit- Select to cap the allowable hours that can be billed per provider per day.
- Use After Hours Service Limit- Select to cap the allowable services per patient per day.