prolonged care Archives

Coding for Prolonged Services | Webinar

Recorded April 17, 2025
1 CEU expires 4/30/26

Coding for prolonged services requires practitioner education, careful documentation and coder oversight. These codes are the opposite of “set and forget.” CPT and CMS use different codes and have different time thresholds. For some services, CMS allows time spent on services done on a different date!

Coding Guide – Prolonged Services

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 […]

Non Face-to-Face Prolonged Service – 99358

This article covers: CPT® Rules for Prolonged Care Non Face to Face Using 99358 for phone calls Are Start and Stop Times Required for Non Face-to-Face Prolonged Care Services? 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) […]