When and how to use time as a billing factor

Why This Topic Matters

Time-based billing can change code selection and payment in pediatric care, so accurate documentation and awareness of the applicable guidance are important for compliant claim submission.

Article Sections

1. Counseling and coordination of care

   Introduces the use of time when counseling or coordinating care is a major part of the visit. Covers the general E/M framework and related time-based guidance for pediatric encounters.

2. Hospital discharge day management

   Discusses time considerations for discharge day services in the hospital setting. Includes the broader context of documentation and timing for discharge-related reporting.

3. Prolonged services

   Reviews the prolonged services category and how time thresholds relate to reporting. Addresses the outpatient and inpatient code families associated with these services.

4. Critical care codes

   Covers time-based reporting for pediatric critical care in the outpatient setting. Notes the age-related setting context and the code family used for these services.

5. Times for counseling/coordinating care visits

   Provides a time reference table for selecting office visit levels based on counseling or coordination of care. Includes new and established patient visit groups.