The system automatically calculates the
Prolonged Service code and units when the following is true:
- 99205 or 99215 is the primary Evaluation and Management code
- Time- when documented Time is more than 74 minutes for a new patient (99205) or above 54 minutes for an established patient (99215)
The
Prolonged Service fields are read-only. If Medicare is the encounter level insurance, the system automatically selects the
Medicare Beneficiary check box to activate the Medicare guidelines for the prolonged service code calculation.
Note: If Medicare is not present for the encounter level insurance, you can select the Medicare Beneficiary check box to apply the Medicare guidelines for prolonged service code calculation.
