After hours and weekend care (professional)
Reimbursement policy describing Priority Health's payment and coding rules for primary care after-hours services for commercial members; excludes Medicare, Medicaid, and Healthy Michigan Plan members and outlines documentation, place-of-service, and modifier guidance.
Transitioned policy from a webpage into this PDF document.
Added the place of service (POS) requirements for codes 99050 and 99051.
After-hours care billed with POS 20 or a specialty of urgent care will be denied.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.