Wiki Coding for 98960 and auditing

[carolanntomko]

If the educator spends more than 30 minutes with the one individual for CPT 98960 as stated in book, do they charge the code again? What modifier would be used?; Other than time, is there other criteria that must be met?

 

[mlbaker1974]

98960

If the educator spends more than 30 minutes with the one individual for CPT 98960 as stated in book, do they charge the code again? What modifier would be used?; Other than time, is there other criteria that must be met?

Per CPT 98960 is for each 30 minutes; individual patient. They can only bill in 30 minute blocks so if they counseled for an hour they would bill it twice but if the counseling was for 45 minutes then they would only bill 98960 once. I don't believe a modifier is necessary.