Use time to bill for critical care, prolonged services

Why This Topic Matters

Accurate time documentation can affect whether services are reported at all and which time-based add-on codes are eligible. The topic matters to urology practices because incomplete or mismatched documentation may change how a visit is billed under CPT and Medicare rules.

Article Sections

1. Critical care services

   Discusses time documentation concepts for critical care reporting and the general relationship between documented minutes and billing levels. It also addresses how multiple sessions in the same day are treated conceptually.

2. Prolonged services

   Covers prolonged services in office and inpatient settings, including their status as add-on services and the role of companion codes. The section also introduces general time-based reporting concepts and base-time limitations.

3. Calculating time units

   Explains how documented time is evaluated for both critical care and prolonged services and how base time affects the calculation. It also notes that the time need not be continuous and distinguishes between service types with and without a base time.

4. Prolonged services payment for face to face only

   Addresses Medicare payment policy issues for prolonged services and distinguishes face-to-face from non-face-to-face services. The section references Medicare manual guidance on what is included in payment.