Prolonged Services (99417 / G2212 Units)
Prolonged-services coding: for the primary E&M code, payer, and total time, which prolonged code (Medicare G2212 or AMA 99417) applies and how many units.
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Example
- Primary E&M code the prolonged-services add-on attaches to
- 99205 -- office/outpatient new (60-74 min)
- Whose prolonged-services rule to apply
- Medicare (G2212 / G0316)
- Total time in minutes
- 90
Result: Medicare 99205 at 90 minutes -> G2212 x1 (Medicare floor 89 min; the AMA 99417 floor is 75 min).
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What you enter
- Primary E&M code the prolonged-services add-on attaches to
- Total time in minutes
- Whose prolonged-services rule to apply: medicare (G2212) or ama (CPT 99417)
How this is calculated
AMA CPT 99417 (office/outpatient) and 99418 (inpatient/observation); CMS G2212 / G0316 for Medicare. The AMA add-on starts 15 min past the primary code minimum time, the Medicare add-on 15 min past its maximum -- a higher floor. Each unit = 15 min. CMS Pub. 100-04 Ch. 12. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
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