New Medicare Codes OUTPATIENT Billing Code Location of Care Definition Reimbursement F2F Prolonged Service Outpatient 99354 IL, ALF, MC Prolonged Services with Direct Patient Contact - when a clinician provides services beyond the usual service in the outpatient setting. Documentation must show additional time (b/t 30-74 min) was above and beyond time spent performing the E/M service. 138.67 F2F Prolonged Service Outpatient 99355 Same as above but for additional time. Documentation must show additional time (b/t 75-104 min) was above and beyond time spent performing the E/M service. 104.54

New Medicare Codes INPATIENT Billing Code Location of Care Definition Reimbursement F2F Prolonged Service Inpatient 99356 LTC, SNF, Hospital Prolonged Services with Direct Patient Contact - when a clinician provides services beyond the usual service in the inpatient setting. Documentation must show additional time (b/t 30-74 min) was above and beyond time spent performing the E/M service. 98.35 F2F Prolonged Service Inpatient 99367 Same as above but for additional time. Documentation must show additional time (b/t 75-104 min) was above and beyond time spent performing the E/M service.

WITHOUT DIRECT PATIENT CONTACT New Medicare Codes WITHOUT DIRECT PATIENT CONTACT Billing Code Location of Care Definition Reimbursement Non F2F Prolonged Service 99358 ALL Prolonged Services without Direct Patient Contact - Documentation must show additional time (b/t 30-74 min) was above and beyond time spent performing the E/M service. 119.56 Non F2F Prolonged Service 99359 57.52

Dementia Care Plan Code: G0505 New Medicare Codes Dementia Care Plan Code: G0505 Multidimensional assessment that includes cognition, function, and safety; evaluation of neuropsychiatric and behavioral symptoms; review and reconciliation of medications; and assessment of the needs of the patient’s caregiver. Informational Guide Website: http://www.alz.org/careplanning/downloads/care-planning-toolkit.pdf