Prolonged Service

Prolonged Service 99354 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour

Prolonged Service 99354 Example 99213 Typical time = 15 min (found in CPT manual) If spend 15 + 60 = 75 minutes, bill 99213 + 99354 (list separately in addition to EM)

Prolonged Service 99354 Time Measurement A unit of time is attained when mid-point is passed An hour is attained when 31 minutes is elapsed

Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 31 = 46 minutes, bill 99213 + 99354

each additional 30 minutes Prolonged Service 99355 Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes

Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 60 + 30 = 75 minutes, bill 99213 + 99354 + 99355 (list separately in addition to 99354)

Prolonged Service 99354 Example 99213 Typical time = 15 min If spend 15 + 60 + 16 = 91 minutes, bill 99213 + 99354 + 99355 (list separately in addition to 99354)

Prolonged Service PAYMENT (Medicare 2013) 99354 2.86 x 34.023 = $97.31 99355 2.8 x 34.023 = $95.26

CPT Typical Time for Code Threshold Time to Bill 99354 Threshold Time to Bill 99354 + 99355 99201 10 40 85 99202 20 50 95 99203 30 60 105 99204 45 75 120 99205 90 135

CPT Typical Time for Code Threshold Time to Bill 99354 Threshold Time to Bill 99354 + 99355 99212 10 40 85 99213 15 45 90 99214 25 55 100 99215 70 115

Prolonged Service Use 99354/99355 also with 99324-99337 Rest Home Services 99341-99350 Home Services

Coding Update file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Whats New Coding Update/2013 Coding Update.ppt