The provider must be in the room with the patient the entire time you are billing for with the prolonged codes. I am not certain Medicare will reimburse for this but I do know the documentation needs to be perfect.We have two providers that offer this service. We code an e/m plus the additional code for monitoring the patient. The provider has to indicate in the office note how much time was spent during the entire visit. We use 99354 for the first hour and 99355 for each additional 30 min. We haven't had a Medicare patient come in for this yet. They have all be Medicaide of Washington patients so far.
Nichole