HCPCS code G0317: Prolonged nursing facility evaluation and management service, additional 15 minutes

No. For G0317, CMS requires that only the time spent on the date of the nursing facility service be counted. Time before or after the encounter date does not apply toward eligibility.

No. While 99418 is listed in CPT, CMS does not reimburse using this code in nursing facility settings; instead, HCPCS G0317 must be used for Medicare claims.

The medical record should detail how the provider spent the additional time, including face-to-face care and non-face-to-face tasks (e.g., coordinating care, counseling, ordering tests). Specific statements like “spoke with cardiology about treatment options” or “reviewed past medical records and updated care plan” enhance defensibility.