Urgent Care Centers (UCCs0 are the delivery of ambulatory care in a facility dedicated to unscheduled, walk-in care outside a hospital emergency department.
Billing Requirements
• Place of service “11” or “20”
• UCCs are reimbursed based on the following E/M CPT codes per the provider’s agreement:
o Level 1
° 99201
° 99202
° 99211
° 99212
o Level 2
° 99203
° 99213
o Level 3
° 99204
° 99205
° 99214
° 99215
• UCCs should itemize all services rendered to the member, including the E/M code.
• To ensure appropriate reimbursement when rendering additional services (i.e., sutures, basic diagnostics, imaging and laboratory tests), the modifier 25 should be applied to the appropriate E/M code.