For a 75-minute encounter, which codes apply for Medicare prolonged time with 99215?

For a 75-minute encounter, which codes apply for Medicare prolonged time with 99215?

• A. 99215 only
• B. 99215x1 and G2212x1
• C. 99215x2
• D. 99215x1 and G2212x2

Answer: (B)

The concept tested is how Medicare accounts for prolonged time in office/E/M visits. For an established patient visit coded as 99215, the base code covers a typical duration (approximately 40–59 minutes). When the encounter lasts longer, you add a separate prolonged-time code (G2212) for each additional 15-minute increment beyond that base time. In a 75-minute encounter, you’re about 16–20 minutes past the first hour, which fits one 15-minute increment. So you report 99215 for the encounter plus one unit of G2212 to reflect the extra 15 minutes. You don’t bill 99215 twice, and you wouldn’t add two units of G2212 unless there were two separate 15-minute increments beyond the base, which would indicate a longer total time.

The concept tested is how Medicare accounts for prolonged time in office/E/M visits. For an established patient visit coded as 99215, the base code covers a typical duration (approximately 40–59 minutes). When the encounter lasts longer, you add a separate prolonged-time code (G2212) for each additional 15-minute increment beyond that base time. In a 75-minute encounter, you’re about 16–20 minutes past the first hour, which fits one 15-minute increment. So you report 99215 for the encounter plus one unit of G2212 to reflect the extra 15 minutes. You don’t bill 99215 twice, and you wouldn’t add two units of G2212 unless there were two separate 15-minute increments beyond the base, which would indicate a longer total time.