Prolonged services codes function as add-on codes to the highest-level Evaluation and Management (E/M) services in certain categories. To use prolonged care, providers must select the primary code based on time, which is explicitly stated in both the CPT® and HCPCS definitions of prolonged services. For billing purposes, the full 15 minutes of prolonged services […]
Coding for Prolonged Services: CPT and HCPCS Codes
Common rules: Prolonged services codes are add-on codes to the highest level E/M services in certain categories. In order to use prolonged care, the primary code must be selected based on time. This is in the CPT and HCPCS definition of prolonged services. Prolonged services codes may only be added to the highest-level code in […]
Code Prolonged Services with Confidence | Webinar
Event date April 17, 2025
Coding for prolonged services requires practitioner education, careful documentation and coder oversight. These codes are the opposite of “set and forget.” This webinar will describe the CPT and HCPCS codes and the conflicting rules related to them. Participants will leave with recommendations for educating practitioners, and with charts showing base codes, add-on codes and time thresholds.
Non Face-to-Face Prolonged Service – 99358
There are two time-based CPT codes for non-face-to-face prolonged care services. These codes may not be used on the day of an Evaluation and Management (E/M) service, such as an office visit or hospital service. Physicians and other qualified health care professionals who have E/M in their scope of practice may use these codes. CMS […]