Healthcare providers may bill the appropriate E/M procedure code(s) that represent the time spent observing and monitoring the member post-administration. Study the table below for more information:
| CPT Codes | Code Description |
| 99205 | Office or any other outpatient visit for the E/M of a new patient, which requires a medically appropriate history and /or examination and a high level of medical decision making. When using time for code selection, 60 to 74 minutes of the total time is spent on the date of the encounter. For services 75 minutes or longer, use prolonged services code “99417”. |
| 99215 | Office or any other outpatient visit for the E/M of an established patient, which requires a medically appropriate history and/or examination and a high level of medical decision making. When using time for code selection, 40 to 54 minutes of the total time is spent on the date of the encounter. For services 55 minutes or longer, use prolonged services code “99417”. |
| 99417 | Prolonged office or any other outpatient E/M service(s) beyond the minimum required time of the primary procedure which has been selected using total time, requiring total time with or without direct patient contact beyond the usual service, on the date of the primary service, each 15 minutes of total time (list separately in addition to codes “99205” and “99215” for office or other outpatient E/M services). |
Please note that HCPCS codes “G2082” and “G2083” should not be billed to the NYS Medicaid program, because they are a bundled payment, which is not eligible for rebate collection per Federal rule, and as such, they are not listed as covered by the program. These codes are only authorized for use on Medicare crossover claims.
Source:
Discover more from Doctor Trusted
Subscribe to get the latest posts sent to your email.
