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TIME factor minimum requuirements

  1. Default TIME factor minimum requuirements
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    If more than 50% of a visit involves counseling and coordination of care, is 40 minutes spent with patient a 99215?. (assuming details about what the counseling consists of are clearly documented and the total time with over 50% counseling /coordination of care is documented.)
    How about 25 total time correctly documented, would that be a level 4?
    this regards established patients
    Thank you
    Last edited by wynonna; 09-28-2018 at 12:23 PM.

  2. Default
    You are correct! 40 mins is the 99215 and 25 mins is 99214 as long as the documentation supports. Below is an excerpt from CMS E/M guidelines regarding the billing based of time.

    When counseling and/or coordination of care dominates (more than 50 percent of) the
    physician/patient and/or family encounter (face-to-face time in the office or other outpatient
    setting, floor/unit time in the hospital, or NF), time is considered the key or controlling
    factor to qualify for a particular level of E/M services. If the level of service is reported
    based on counseling and/or coordination of care, you should document the total length
    of time of the encounter and the record should describe the counseling and/or activities
    to coordinate care

  3. Default
    Thank you!

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