When Does TIME Prevail-Understanding the E/M Time Factor

Time - Needed Criteria

If the physician document total time and suggests that counseling or coordinating care dominates more than 50% of the encounter, time may determine the level of service. Documentation may refer to: Prognosis, differential diagnosis, risks, benefits of treatment, instructions, compliance, risk reduction or discussion with another health care provider.

If all answers are YES to the following queries, you may select a level of service based on time:

  1. Does the documentation reveal total time? (face to face in an outpatient setting)
  2. Does the documentation describe the content of counseling or coordination of care?
  3. Does the documentation reveal that more than half the time was counseling or coordinating care?

Levels = Time

Level Time Level Time
99201 new out pt 10 min 99211 est. out pt 5 min
99202 20 min 99212 10 min
99203 30 min 99213 15 min
99204 45 min 99214 25 min
99205 60 min 99215 40 min
99241 out pt consult 15 min 99251 in pt consult 20 min
99242 30 min 99252 40 min
99243 40 min 99253 55 min
99244 60 min 99254 80 min
99245 80 min 99255 110 min
Code Description Time
99302 Initial nursing facility care, per day, for the evaluation and management of a patient; requiring detailed or comprehensive history and exam and straightforward or low-complexity medical decision making (MDM) 25 min
99305 ...;comprehensive history and exam; moderate complexity MDM 35 min
99036 ...;comprehensive history and exam; high complexity MDM 44 min
99307 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: problem focused interval history, problem focused exam, straightforward MDM 10 min
99308 ...;expanded problem focused interval history, expanded problem focused exam, low-complexity MDM 15 min
99309 ...;detailed interval history, detailed exam, moderate complexity MDM 25 min
99310 ...;comprehensive interval history, comprehensive exam, high complexity MDM 35 min
99318 Evaluation and management of a patient involving an annual nursing facility assessment, which requires a detailed interval history, comprehensive exam and low moderate complexity MDM 30 min