text: JL Home ► Claims ► Professional Services where Time is a Primary Factor
  While time has been included in the definitions of the majority of professional service codes for a number of years now, there is a difference between codes that list "typical" time and codes where time is a primary factor.
  Typical time noted in the code descriptors are averages that represent a range of times, and are designed to assist providers with determining the most appropriate level of code.
  In addition to codes that have a "typical" time component, there are a variety of professional codes where time is a primary factor in the code. However, even in cases where time is a primary component, there are differences in the requirements for utilizing these codes. It is important to review the requirements of a code prior to submitting it on a claim.
  Required time is the necessary time a provider spends rendering the service to the beneficiary, and the appropriate selection of the code includes a firm time basis. There are also codes within the Evaluation & Management code set that use approximate time thresholds, codes that involve a time range, and codes that are "add-ons" for additional time spent rendering a service.
  Bill appropriate E/M; not critical care
  99354 (not reported separately)
  Requiring direct patient contact; < 30 minutes
  Before and/or after direct patient care; 1st hour
  99415 (not reported separately)
  Prolonged clinical staff; < 45 minutes
  99360 (not reported separately)
  Standby service; < 30 minutes
  99366 (not reported separately)
  Medical team conference without direct patient/family contact; <30 minutes
  99367 (not reported separately)
  Medical team conference without direct patient/family contact; < 30 minutes
  Provider to an individual; approximately 15 minutes
  Behavioral change interventions, individual; >3 minutes and up to 10 minutes
  99408 (not reported separately)
  Group setting; approximately 30 minutes
  Telephone services; 5-10 minutes
  Interprofessional telephone/internet consultations; 5-10 minutes
  1st 30-74 minutes
  Advance care planning, 1st 30 minutes
  Centers for Medicare & Medicaid Services (CMS) Internet Only Manual (IOM) 100-4, Chapter 12, Section 30.6 E/M Service Codes