tci Part B Insider - 2003 Issue 10

REIMBURSEMENT: When You Take Extra Time, Make It Count

If your physician is spending more than the usual amount of time with a patient, you could let reimbursement slip through your fingers if you don't bill correctly.Medicare will pay for prolonged service for visits that last past certain time frames. The rules are different for inpatient and outpatient visits (see chart on next page), but the constant is that spending extra time should yield extra payment. Private payers generally don't reimburse prolonged service codes (99354-99357), so coders who are new to Medicare may not understand all the ins and outs of billing for them, says Barbara Cobuzzi...

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