Wiki 99417

[mazziotn@ebnhc.org]

For the prolonged code 99417 what is the time range for this for est. patient ..55-69min or is it 70 min. Does it have to be the full 15 min.past. Cpt book is 55-69min. but cms is 70 min.
so im not sure which to go by. thanks for your help

 

[Cheezum51]

For 99417, the first unit for billing that starts at 15 minutes after the minimum time for the code. Therefore, Once you reach 55 minutes, on a 99215 E/M visit, you can bill the first unit for the 99417. Once you pass 69 minutes, you can bill two units of 99417 and so on for each succeeding 15 minute period.

For 2024, I'm assuming that the G2212, used for prolonged services for Medicare/Medicaid patients, the first unit for that starts once you exceed 70 minutes for the 99215. It is also billed in 15 minute increments.

Tom Cheezum, OD, CPC, COPC

 

[mazziotn@ebnhc.org]

great thank you, is there a reference page i can get this from.

 

[Cheezum51]

Look in the 2023 and 2024 CPT books. It gives the times for the codes there and how to calculate the 99417.

Tom Cheezum, OD, CPC, COPC