I heard coding for prolonged services is changing in 2021. Is that true?
Yes. There will be a new CPT® code for 15 minutes of prolonged care services to be used only with codes 99215 and 99205. The AMA will release the new code number in the 2021 CPT® set.
It will be used to report total time on the day of an office visit, including face-to-face and non-face-to-face time, when the base code (99215 or 99205) is selected based on time alone.
The existing face-to-face prolonged care codes 99354 and 99355 may not be used with office and other outpatient codes 99202—99215 beginning in January of 2021. Those codes may still be reported with other services, such as the highest level of psychotherapy and domiciliary and home visits.
And, starting in January, non-face-to-face prolonged care codes 99358 and 99359 may not be reported on the same day as codes 99202-99215.
Reporting prolonged services is getting more complicated. Join us in September for our monthly webinar on coding for prolonged services.