This chart demonstrates how the 99417 is reported if the payer is following CPT logic. Work with your payers to know how they want this to be reported.

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This chart demonstrates how the G2212 is reported if the payer is following CMS logic. Work with your payers to know how they want this to be reported.

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G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (List separately in addition to CPT codes 99205, 99215 for office or other outpatient evaluation and mana

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On December 1, 2020 the Centers for Medicare and Medicaid released the 2021 final rule for the Physician Fee Schedule. In the final rule was notification from CMS that while they recognize prolonged services, they disagree with CPT on the threshold time needed to allow the reporting of prolonged services. To that end, CMS released a different code that is billable to Medicare.