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CPT Codes

CPT Codes

CPT Codes

Code Description
99354-Prolonged E&M/psyctx serv outpat, 30-74min
  • Requestor code. Use in addition to 99452 for the time spent on the interprofessional tel/Internet/EMR discussion with consultant if the time exceeds 30 min covered by 99452.  Pat. is present in the office or other outpatient setting.
  • Use code only once per date, to report the total duration of face-to-face time, even if the time spent on that date is not continuous
  • E.g.: if total duration of service is 30-74 min, report 99452x1 and 99354x1; if 75-104 min, report 99452x1, 99354x1, 99355x1
99355-Prolonged E&M/psyctx serv outpat add'l 30min
  • Requestor code. Prolonged serv. code, patient present with requesting QHP in office/outpatient setting
  • List separately in addition to code for prolonged service 99354
  • E.g.: if total duration of service is 30-74 min, report 99452x1 and 99354x1; if 75-104 min, report 99452x1, 99354x1, 99355x1
99356-Prolonged service inpat/observ, 30-74min
  • Requestor code. Use in addition to 99452 for the time spent on the interprofessional tel/Internet/EMR discussion with consultant if the time exceeds 30 min covered by 99452. Requestor is at the bedside and on the patient’s floor/unit in the hospital/nursing facility
  • Use code only once per date, to report the total duration of face-to-face time, even if the time spent on that date is not continuous
  • E.g.: if total duration of service is 30-74 min, report 99452x1 and 99356x1
99357-Prolonged service inpat/observ, add'l 30 min
  • Requestor code. Prolonged serv. code, patient present with requesting QHP at the bedside and on the patient’s floor/unit in the hospital/nursing facility
  • List separately in addition to code for prolonged service 99356
  • E.g.: if total duration of service is 30-74 min, report 99452x1 and 99356x1; if 75-104 min, report 99452x1, 99356x1, 99357x1
99358-Prolonged serv. w/o pat contact, 30-74min
  • Requestor code. Use in addition to 99452 if the interprofessional telephone/Internet/electronic health record E/M service occurs when the patient is not present and the time spent in a day exceeds the 30 minutes covered by 99452 
  • 99358 may be reported on a different date than 99452
  • E.g.: if total duration of service is 30-74 min, report 99452x1, 99358x1; if 75-104 min, report 99452x1, 99358x1, 99359x1
99359-Prolonged serv. w/o pat contact add'l 30
  • *Requestor code, prolonged serv. code, patient not present w/ requesting QHP
  • *List separately in addition to code for prolonged service 99358
  • E.g.: if total duration of service is 30-74 min, report 99452x1, 99358x1; if 75-104 min, report 99452x1, 99358x1, 99359x1
99446-Interprof Tel/Internt/EMR Cons. 5-10 min V+W
  • Consultant code, QHP to QHP, verbal and written report
  • Frequency: do not report if pt seen in the past 14 days or if ITC results in transfer or in-person consult in the next 14 days 
  • Do not report more than once in 7 days
  • Time based service: report if >50% service is verbal discussion
99447-Interprof Tel/Internt/EMR Cons.11-20 min V+W
  • Consultant code, QHP to QHP, verbal and written report
  • Frequency: do not report if pt seen in the past 14 days or if ITC results in transfer or in-person consult in the next 14 days 
  • Do not report more than once in 7 days
  • Time based service: report if >50% service is verbal discussion
99448-Interprof Tel/Internt/EMR Cons. 21-30min V+W
  • Consultant code, QHP to QHP, verbal and written report
  • Frequency: do not report if pt seen in the past 14 days or if ITC results in transfer or in-person consult in the next 14 days 
  • Do not report more than once in 7 days
  • Time based service: report if >50% service is verbal discussion
99449-Interprof Tel/Internet/EMR Cons. >=31 V+W
  • Consultant code, QHP to QHP, verbal and written report
  • Frequency: do not report if pt seen in the past 14 days or if ITC results in transfer or in-person consult in the next 14 days 
  • Do not report more than once in 7 days
  • Time based service: report if >50% service is verbal discussion
99451-Interprof Tel/Internet/EMR Cons. >=5  W
  • Consultant code, QHP to QHP, written report
  • If >50% time spent on written assessment, management and documentation (as opposed to verbal discussion), report this code
99452-Interprof Tel/Internt/EMR REFERRAL svc,30min
  • Requestor code (physician or other QHP), first 16-30 minutes
  • Report 99452 if spending 16-30 minutes/day preparing for the referral and/or communicating w/ consultant. Do not report more than 1x in 14-day period


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Topic 1456 Version 1.0