1. 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 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 min) was above and beyond time spent performing the E/M service.
104.54

2. 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 min) was above and beyond time spent performing the E/M service.
98.35
F2F Prolonged Service Inpatient 99357
Same as above but for additional time. Documentation must show additional time (b/t min) was above and beyond time spent performing the E/M service.

3. 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 min) was above and beyond time spent performing the E/M service.
119.56
Non F2F Prolonged Service 99359
Prolonged Services without Direct Patient Contact - Documentation must show additional time (b/t min - bill both ) was above and beyond time spent performing the E/M service.
57.52

4. 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.
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