MedicaidBilling CodesMedium impact
Clarifying Guidance for Procedure Code 99417 pdf
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice +14 more·Provider Bulletin
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated guidance for CPT 99417 (prolonged E/M services), allowing providers to count time spent with or without direct patient contact when billing this add-on code. This change follows 2021 AMA CPT manual guidance and is retroactive to January 1, 2021.
Action Required
Immediately: Billing team and providers must review 2021 CPT manual guidance for documenting and billing CPT 99417. Update documentation templates to reflect that time with or without direct patient contact can be counted for prolonged E/M services. Ensure proper documentation supports billing for each 15-minute increment beyond the primary E/M service time.