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Calculating time: CPT vs. CMS
The physician or qualified health professional must report 15 minutes of prolonged service on the day of the encounter for each unit of service. But be aware that when you should start counting the prolonged time will vary based on whether you’re billing a private payer that uses the CPT code or Medicare or other payer that uses the HCPCS code. Use these decision trees and chart to understand how the guidelines impact the way you code.
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