CPT 99354: Prolonged Service - Outpatient
Prolonged evaluation and management service in the outpatient setting, first 30 minutes beyond the typical time for the primary E&M service.
Documentation Requirements
- Primary E&M service documented separately
- Total face-to-face time documented
- Clinical justification for prolonged service
- Activities performed during prolonged time
- Start and stop times recommended
Billing Tips
- Must be billed with a primary E&M code (99205, 99215, etc.)
- Requires direct patient contact beyond typical E&M time
- First 30 minutes beyond typical time = 99354
- Each additional 15 minutes = 99355
- Document total time and justify medical necessity
- Under 2021 E&M guidelines, consider time-based E&M instead
Frequently Asked Questions
When can I bill 99354?
99354 is appropriate when direct patient contact extends at least 30 minutes beyond the typical time for your primary E&M service. Scribeable tracks encounter time and flags when prolonged service criteria are met.
How does Scribeable help document prolonged services?
Scribeable automatically tracks encounter duration, documents activities performed during extended encounters, and generates compliant notes that justify medical necessity for prolonged service billing.