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Wiki 99417

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shanamarie

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Is anyone aware of a start and stop time requirement for prolonged services? Specifically for 99417?
 
In the CMS final rule for 2021, Medicare decided not to accept 99417 because the CPT wording was not clear as to the specific time requirements. They have created the substitute code G2212 which requires that the maximum time for the base E&M be met before the prolonged time can be counted for the additional code. So for a new patient, the total time required to report the first unit of G2212 in addition to 99205 would be 89-103 minutes; for an established patient, to report it in addition to 99215 requires a total time of 69-83 minutes.

You can find the complete explanation beginning on page 102 in the final rule document here:
 
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