The only billable time is the face to face physician to patient time and must be documented in the medical record by the physician for each time he was in the room. Such as time in x:xx and time out X:XX or time spent 5 min, then another 5 min etc. then IF there is enough time ie 30 minutes beyond the visit level time, for instance if a level 3 were documented then a TOTAL of 45 minutes spent face to face would give you a 99213 plus a 99354. But time spent all along the way must be documented, that means time spent for the ov plus the additional time each time the patient was checked on.
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