Prolonged Service Office or Other Outpatient Services 99417 & G2212

Prolonged Service

Use 99417 & G2212 in conjunction with 99205, 99215 and do not report 99417 on the same date of service as 99354, 99355, 99358, 99359, 99415, 99416

Do not report 99417 for any time unit less than 15 minutes. 

The payers will not reimburse you unless you report it with an appropriate primary code because this code is an add–on code, 

Confirm payer coverage and requirements for this code.

• Medicare requires this code G2212 in place of +99417.
• Private payers require this code 99417 in place of G2212

As an example of proper use, when coding based on time, you report 99205 for a new patient visit lasting 60 to 74 minutes. Once the time reaches 89 minutes, you also may report +G2212 because 89 minutes is 15 minutes beyond the maximum required time of 74 minutes.

When coding based on time, you report 99205 for a new patient visit lasting 60 to 74 minutes. Once the time reaches 75 minutes, you also may report +99417 because 75 minutes is 15 minutes beyond the minimum required time of 60 minutes.

When coding based on time, you report 99215 for an established patient visit lasting 40 to 54 minutes. Once the time reaches 55 minutes, you also may report +99417 because 75 minutes is 15 minutes beyond the minimum required time of 60 minutes.

Total Duration of New Patient Office or Other Outpatient Services (use with 99205)	Code(s)
less than 75 minutes	Not reported separately
75-89 minutes	99205 X 1 and 99417 X 1
90-104 minutes	99205 X 1 and 99417 X 2
105 minutes or more	99205 X 1 and 99417 X 3 or more for each additional 15 minutes
Total Duration of Established Patient Office or Other Outpatient Services (use with 99215)	Code(s)
less than 55 minutes	Not reported separately
55-69 minutes	99215 X 1 and 99417 X 1
70-84 minutes	99215 X 1 and 99417 X 2
85 minutes or more	99215 X 1 and 99417 X 3 or more for each additional 15 minutes