BC Advantage - 2022 Issue 4

Prolonged Services Billed As a Split/Shared Visit

Previously, prolonged services were not allowed to be billed as a split or shared visit. However, Medicare's 2022 Medicare Physician Fee Schedule Final Rule has updated that ruling to allow add-on codes for prolonged services to be reported as a split or shared visit. If all requirements for reporting a prolonged service are met, then the time spent by both the physician and the NPP can be reported. Note: The time of both providers must meet the threshold for reporting prolonged E/M services (60 or more minutes beyond the typical time of the primary service code).It has...

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