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CAPC Palliative Care Discussion Forum
Billing and Finance

In Reply To: Billing by time in 2010
Next Reply: Re:Re:Billing by time in 2010
Next Message: Re:Billing by time in 2010

Post Re:Billing by time in 2010
Author: JulieP [Expert]
Date: Jan 18, 2010 4:31 pm
If you are comparing the time elements for codes 99253-99255 to 99221-99223 (for a Medicare patient) you will find the total times assing in CPT by the AMA for 99221-99223 is less than the assigned times to 99253-99255.
99255 + 99356 = 140 minutes
99223 + 99356 = 100 minutes

**becareful, the time documented for the prolonged care specifically needs to state that you were face-to-face with the patient and it's best that the times for each service are separated in the documentation.

Julie Pipke-CPC, RM MCW
Replies: order by [Date] [Author] [Subject]
+ Re:Re:Billing by time in 2010 (by woody_english on 01/18/2010)
Thank you. If I use, for example, 99223 and add 99356 (for a 100 minute consult), how much of the 100 minutes needs to be face to face with the patient? This time must be documented. I am unclear what proportion of the total time is required. Is this an absolute number of minutes or is the required face to face time a proportion of the total time when the prolonged services codes are used? If CMS is silent on this, that is fine. I have been informally advised that there are new rules about the amount of time required for face to face presence with the patient when prolonged services codes are used.

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