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.

30 minutes beyond primary E&M
2.10 work RVU
5 requirements

Documentation Requirements

  1. 1Primary E&M service documented separately
  2. 2Total face-to-face time documented
  3. 3Clinical justification for prolonged service
  4. 4Activities performed during prolonged time
  5. 5Start 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.

Automate Prolonged Services Documentation

Scribeable captures all required elements for CPT 99354 from your patient conversation. Generate compliant notes in seconds.

Common Diagnoses

C34.90G35I50.23E11.65F33.1

Related Specialties

internal medicineprimary careoncologyneurologygeriatrics

Related Procedures

CPT 992131.30 work RVU

Office Visit Level 3

Established patient office visit with low level of medical decision making.

CPT 992141.92 work RVU

Office Visit Level 4

Established patient office visit with moderate level of medical decision making.

CPT 992152.80 work RVU

Office Visit Level 5

Established patient office visit with high level of medical decision making.

CPT 992031.60 work RVU

New Patient Level 3

New patient office visit with low level of medical decision making.

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

  1. Primary E&M service documented separately
  2. Total face-to-face time documented
  3. Clinical justification for prolonged service
  4. Activities performed during prolonged time
  5. 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.

Related Procedures

Specialties

Compare

Clinical Content

Resources

Getting Started