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

Coding for prolonged services was never easy, and CMS’s decision to use HCPCS codes and different time thresholds complicated coding. It is hardly realistic that a physician, nurse practitioner or physician assistant can keep the rules and time thresholds clearly in their head, unless they are the rare practitioner who uses prolonged care frequently. For […]

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 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 […]

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