Can a prolonged service be based on counseling and/or coordination of care dominating the service?
Yes, however the counseling and/or coordination of care must exceed the typical time for the highest level of service for any type of visit (e.g., new patient visit) by 30 minutes. For example, the typical time for the highest level established patient visit, 99215, is 40 minutes. If the counseling and/or coordination of care total time was 70 minutes or more, both the 99215 and a prolonged service code (99354) can be billed if the documentation requirements are met.
