Prolonged Services: Comparative Differences

Face-to-Face vs. Non Face-to-Face CPT Codes

Face-to-Face ( CPT Codes 99354-99355, 99356-99357)	Non Face-to-Face (CPT Codes 99358-99359)
Have been approved codes for many years	Approved for payment on 1/1/2017
Require exclusive F2F time with the patient	Does not require any F2F time with the patient
Exclusively add-on codes	Independent codes: can be billed alone
Must be billed on the same DOS as the base E/M	Can be billed on the same or a different DOS as the related service
Different code sets for inpatient and outpatient settings	Codes apply in both inpatient, outpatient and SNF settings
Only for use with E/M services	May be used with E/M and other physician services
Documentation requirements well established	Medical records must: support the medical necessity of the service; the time spent; and the fact that the service was not duplicated by other billed services e.g., E/M services or part of a global surgical service It is not sufficient to say, for example: "1 ½ hour of non face-to-face time spent ____."