When submitting claims for services that state major portion thereof, at least half of the minimum time stated in the code must have elapsed. For example, if the code states 15 minutes or major portion thereof; the minimum time that can be spent with the patient in order to submit a claim is eight minutes.
When more than one call is required, each call must be the full 15 minutes. The last call must make up a major portion of the required time. For example, if the physician spent 53 minutes with the patient, three full 15-minute units have been spent as well as the major portion of one call; therefore a total of four calls may be claimed. If the physician spends 50 minutes with the patient, only three calls could be claimed.
For more advice from AMA staff on any billing issues, including explanations of recent billing changes, please email AMA billing staff at [email protected].
