tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Foil Prolonged Services Coding Conundrums With This Handy Chart

Tip: Don’t forget about CY 2023 MPFS policies. If you’re confused about which code to use for your Medicare and private payer patients — as well as how best to calculate at what point the service will require a prolonged services add-on code — check out the following chart. Remember: Per the 2023 Medicare Physician Fee Schedule (MPFS) final rule, the Centers for Medicare & Medicaid Services (CMS) is still not recognizing consult codes, which is why you won’t be able to use a prolonged service G code in addition to 99245 or 99255. ...

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