1. Prolonged Service

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

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

4. 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

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

6. 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

7. Prolonged Service 99354 Example 99213 Typical time = 15 min
If spend = 75 minutes,
bill
(list separately in addition to 99354)

8. Prolonged Service 99354 Example 99213 Typical time = 15 min
If spend = 91 minutes,
bill
(list separately in addition to 99354)

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

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

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

12. Prolonged Service Use 99354/99355 also with
Rest Home Services
Home Services

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