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Thread: Prolonged services vs billing est. pt visits (99211 - 99215)

  1. #11


    AAPC: Back to School
    If you have the documentation for the office visit 99214 and codes 99354 and 99354 where would you add the modifer 25

  2. #12
    Join Date
    Apr 2007
    Columbia, MO


    the 98960 is a code for nonphysicians and nonpractitioners, you use that code for ancillary personnel such as the nurse. I have not had any issue with Medicare or BCBS paying for that code. When you have an office visit and a prolonged code you do not need the 25 as the 99354 is add on. Also I have had reports from some states that APRN, PA and NPs are not allowed to use the prolonged time codes for their billing so FYI you might want to check on that first.

    Debra A. Mitchell, MSPH, CPC-H

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