news article details

New Evaluation and Management Frequently Asked Questions for Prolonged Services

We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing for CPT codes 99354-99356, 99358-99359, and G2212 in the outpatient/office/inpatient setting.

5. Do CPT codes 99354-99356 and 99358-99359 still apply to services in the outpatient/office setting?

Answer: As of 1/1/2021, these code sets are no longer applicable to outpatient/office E/M services. The only permissible code for prolonged service(s) in these settings is G2212. Of note, G2212 may only be applied to relevant time spent by the provider before, during, and after an E/M service on the actual date of service of the face-to-face encounter. Added 4/1/2022

6. Are CPT codes 99358-99359 applicable for prolonged services in the inpatient setting?

Answer: Yes, in CY 2022, these codes may still be used as appropriate to describe prolonged services in the inpatient setting. Added 4/1/2022

Review all the Evaluation and Management Frequently Asked Questions for Prolonged Services.

​​​​​​​Posted 4/1/2022