If you’re confused about which code to use for your Medicare and private payer patients — as well as how best to calculate at what point the service will require a prolonged services add-on code — check out the following chart.

Remember: Per the 2023 Medicare Physician Fee Schedule (MPFS) final rule, the Centers for Medicare & Medicaid Services (CMS) is still not recognizing consult codes, which is why you won’t be able to use a prolonged service G code in addition to 99245 or 99255.