Prolonged services cannot be reported if the service duration is less than what?

Prolonged services are a specific category of coding that allows for additional time spent on a patient’s care beyond typical service durations. To qualify for reporting prolonged services, a minimum duration of service must be met before these additional hours can be billed.

In the case of prolonged services, it is essential to note that reporting cannot occur unless the service duration exceeds the standard time specified by coding guidelines, which is set at 30 minutes. This is in alignment with the requirements outlined in the guidelines for prolonged service codes, indicating that only after reaching this threshold can the provider report the service as prolonged.

This standard ensures that the time is substantial enough to justify additional billing and that the services provided were indeed beyond the routine follow-up or encounter expectations typically associated with E/M services. Thus, if the prolonged service time is less than 30 minutes, it does not meet the criteria for additional coding.