See why 30 minutes more than usual is the magic requirement. If your ob-gyn spends more continuous time with a patient than what's specified for 99215 or 99225, you should consider appending modifier 21 but this won't be the case in 2009. CPT eliminates modifier 21 and directs you to go straight to prolonged service codes instead. Payers in some areas do not recognize modifier 21, experts say. Prediction: Expect an easier time getting paid for prolonged services that a physician provides face-to-face to a patient. Most payers recognize prolonged services codes for direct patient care, but not for indirect care.