Here is some info from our FI. This is right from their billing guidelines for E&M form New England hope this hope this helps
Counseling and/or Coordination of Care (Time-Based)
When an E/M service is dominated by counseling and/or coordination of care (the counseling
and/or coordination of care represents more than 50% of the total time with the patient) in a faceto-
face encounter between the physician or NPP and the patient in the office/clinic or the floor
time (in the scenario of an inpatient service), then the E/M code is selected based on the
typical/average time associated with the code levels. The time approximation must meet or
exceed the specific CPT code billed (determined by the typical/average time associated with the
E/M code) and should not be “rounded” to the next higher level. In those E/M services in which
the code level is selected based on time, prolonged services may only be reported with the
highest code level in that family of codes as the companion code.
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