Previously, prolonged services were not allowed to be billed as a split or shared visit. However, Medicare's 2022 Medicare Physician Fee Schedule Final Rule has updated that ruling to allow add-on codes for prolonged services to be reported as a split or shared visit. If all requirements for reporting a prolonged service are met, then the time spent by both the physician and the NPP can be reported. 

Note: The time of both providers must meet the threshold for reporting prolonged E/M services (60 or more minutes beyond the typical time of the primary service code).

It has been determined that in order to report prolonged services as a split or shared visit, the physician or NPP that has performed the substantive (i.e., majority) portion of the service will do the reporting. The reporting physician/NPP will report both the primary service and the prolonged service. 

For shared office/outpatient visits, the substantive portion of the service can be determined by either:

This option is valid for the year 2022 and only for office/outpatient visits. See the CMS table below for more information as to what codes to use and what rules apply to each year. Beginning in year 2023, the substantive portion must be determined by time only. 

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