Building Trust and Improving Overall Safety

Medication guides contribute to a broader culture of safety in healthcare. Patients often receive a lot of information during appointments, and it can be difficult to remember everything. A medication guide provides a dependable reference that patients and caregivers can revisit anytime. This reduces uncertainty and builds trust, allowing people to feel more comfortable with their treatment plan.

In addition, medication guides help standardize essential safety information. Everyone who receives the medication gets the same clear, evidence-based instructions, reducing the chance of misunderstandings or inconsistent advice.

Common Questions for Physicians:

For physicians placing infectious disease testing orders for patients, can they get reimbursed for their time to:

1. Explain lab test results and treatment plans to patients
2. Provide patients a printed Patient Instruction about the antibiotics recommended/prescribed with the potential side effects, Drug-Drug Interaction and Drug-Food Interaction

If so, what is the proper CPT codes to use for reimbursement?

Short answer: Yes, you can get reimbursed.

The time a physician spends explaining infectious disease test results, discussing the antibiotic plan (including DDI/DFI risks), and giving patient-specific instructions is billable as part of an E/M visit.

• Select 99202–99215 by MDM or total time; the 2021+ E/M rules explicitly include counseling/education and independently interpreting results and communicating them to the patient in the countable time.
• Printed handouts are ordinarily bundled into the E/M service and not paid separately.

Which codes to use (by scenario)

Easy Guide to Billing Long Result-Review Visits and Antibiotic Counseling

When you review test results with a patient and talk about antibiotics, the billing depends on how long the visit takes and whether it was in person, video, phone, or portal message.

When Time Counts as “Prolonged”

Commercial Insurance You can add a “prolonged time” code (+99417) when:

• New patient (99205): Visit lasts 75–89+ minutes
• Established patient (99215): Visit lasts 55–69+ minutes
• More time = more units of +99417.

Medicare Uses a different prolonged code (G2212):

• New patient (99205): Starts at 89–103 minutes
• Established patient (99215): Starts at 69–83 minutes
• Again, more time = more G2212 units.

What Doesn’t Get Paid Separately

• Printed instruction sheets (like antibiotic side effects or interaction lists) are included in the visit. Insurance almost never pays extra for them.
• General education that isn’t specific to that patient doesn’t count toward visit time. Patient-specific = counts. Generic = doesn’t.

How to Choose the Right Code

1. Was there a real visit (in person or video)?
   • Use 99202–99215.
   • Add prolonged time code if the visit truly went long.
2. Was it phone only?
   • Commercial insurance: 98008–98015 + modifier 93.
   • Medicare: 99202–99215 + modifier 93.
   • Quick 5–10 min check-in: 98016.
3. Was the conversation through the portal over several days?
   • 99421–99423.
4. Printed instructions?
   • Included in the visit. No separate payment.

Bottom Line

• Bill the result review and antibiotic counseling as 99202–99215.
• Add +99417 (commercial) or G2212 (Medicare) only if the visit was really long.
• Audio-only visits have special rules.
• Printed instructions aren’t paid separately—just document that you gave them.

How Much More Does Medicare Pay for a Long Visit?

Using 2025 national Medicare rates:

Established Patient

• Long visit (99215 + G2212): $206.69
• Short visit (99212): $54.99
• Difference: +$151.70 (about 4× more)

New Patient

• Long visit (99205 + G2212): $246.80
• Short visit (99202): $69.87
• Difference: +$176.93 (about 3.5× more)

Every extra 15 minutes of prolonged time adds another $31.