Prolonged service codes required

Prolonged service codes are added to evaluation and management codes when the service takes longer than the usual time listed in the current procedural terminology manual. The first four codes are face-to-face codes, applicable to both outpatient/office and inpatient encounters. Face-to-face codes require the service to be provided while the patient is present. If a patient is unconscious, face-to-face codes may not be applied.

A complete breakdown of the prolonged service codes is below:

  • 99354 - The first prolonged period, greater than 30 minutes and up to one hour, in an office setting.
  • 99355 - The additional 30-minute period after the 99354.
  • 99356 - The first prolonged period, greater than 30 minutes and up to one hour, in an inpatient hospital setting.
  • 99357 - The additional 30-minute period after the 99356.
  • 99358 - This non face-to-face prolonged service code (the first 30 - 60 minutes) must be used before or after an evaluation and management visit, and is not an add-on code. This code may be used to review extensive records on a new patient or to contact family after a patient visit (on the phone or in person). A note should be created for this service.
  • 99359 – Each additional half hour of time, after the 99358 is billed, on the same date.

If you have additional questions, please contact Vivian Furtado in the Office of Privacy and Corporate Compliance at 203-336-7859.