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  • How To Use CPT Code 99356 - Updated 2025 - Coding Ahead
    CPT code 99356 is used when a provider has spent additional time on an inpatient or observation evaluation and management service, specifically for the first hour of prolonged service It is essential to report this code in conjunction with an appropriate primary E M code to ensure reimbursement
  • Prolonged service codes 99354, 99355, 99356, 99357, 99358 and 99359 . . .
    99356 - The first prolonged period, greater than 30 minutes and up to one hour, in an inpatient hospital setting 99357 - The additional 30-minute period after the 99356 99358 - This non face-to-face prolonged service code (the first 30 - 60 minutes) must be used before or after an evaluation and management visit, and is not an add-on code
  • Changes to Coding for Prolonged Services in 2023
    Depending on their setting, providers can use these new codes in lieu of CPT codes 99356 (Prolonged service in the inpatient or observation setting), and 99357 (Prolonged service in the inpatient or observation setting)
  • Code and Guideline Changes | AMA - American Medical Association
    Prolonged Services (99354, 99355, 99356, 99417) Code and Guideline Changes This document includes the following CPT E M changes, effective January 1, 2021: • E M Introductory Guidelines related to Office or Other Outpatient Codes 99202-99215 • Revised Office or Other Outpatient E M codes 99202-99215
  • Extend Prolonged Service Smarts With New Codes : E M 2023 - AAPC
    For 2023, CPT® also deletes prolonged service codes +99354 and +99355 In their place, you’ll now use +99417, as CPT® has increased its scope You’ll now be allowed to use it to report prolonged services with: Add This New CPT® Prolonged Service Code
  • CMS Manual System - Centers for Medicare Medicaid Services
    Therefore, medically necessary prolonged services for E M visits and medically necessary time-based visits for counseling and or coordination of care for Nursing Facility Services may be billed with the appropriate prolonged services codes (99356 and 99357)
  • The right way(s) to bill for prolonged care - Todays Hospitalist
    You would not be able to report an inpatient prolonged care code 99356 (prolonged service in the inpatient or observation setting, face-to-face time with the patient, first hour) until the total time for the encounter hits 55 minutes
  • COMPLIANCE ADVISORY - Childrens Hospital Los Angeles
    Depending on the place of service, 99354 or 99356 is used to report the first hour of prolonged service on a given date Either of these codes is used only once per date of service To report either of these codes, the service must extend at least 30 minutes beyond the normal time of the E M code
  • CPT codes changes 2021 for Prolonged Services (99354, 99355, 99356 . . .
    Depending on the location of service, code 99354 or 99356 is used to report the first hour of prolonged service on a given date Even if the time spent by the physician or other qualified health care professional is not continuous on that date, either code should be used only once per date
  • Hard Facts of Coding Prolonged Services - AAPC
    Prolonged service codes 99354-99357 are used when a physician or other qualified health provider performs a prolonged service involving direct (face-to-face) patient contact that goes beyond the usual service in either the inpatient or outpatient (office, clinic, observation, etc ) setting





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