CPT Code 99417 Update – Prolonged Outpatient Evaluation and Management Services
This code may be billed with CPT Codes 99245, 99345 and 99350 effective Jan. 1, 2023.

CPT code 99417 (Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time) is now allowed to be billed with 99245, 99345 and 99350.

Effective Jan. 1, 2023, add on CPT code 99417 is allowed to be billed with the following primary procedure codes:

  • 99245 Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.
  • 99345 Home or residence visit for the evaluation and management of new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.
  • 99350 Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. 

Please resubmit claims if you have received a claim denial for the above code combination for dates of service Jan 1, 2023, to present.  

Contact

NCTracks Call Center, 800-688-6696 

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