Prepare to add new prolonged service codes to your E/M roster

Why This Topic Matters

The proposed change could affect whether and how practices are paid for work performed outside the face-to-face visit. It also matters because the article addresses differences between Medicare’s proposed approach and broader CPT-based reporting practices, which can influence compliance and payer workflow.

Article Sections

1. CMS proposed activation of prolonged service codes

   Introduces the proposed Medicare payment update and the broader billing context for non-face-to-face prolonged services.

2. Add to the well of non-face-to-face services

   Places the proposed change alongside other care-management-related services discussed in recent payment policy.

3. Watch out for different billing rules

   Compares the proposed Medicare approach with other payer and CPT-based reporting expectations and notes potential policy differences.

4. Note 2 additional billing requirements

   Summarizes additional proposal elements involving service timing, overlap with other management services, and CMS’s request for public input.

5. Resources

   Provides a reference table summarizing the service codes discussed in the article and their estimated payment context.