In simple words: This code covers the extra time a healthcare professional spends on a home visit beyond the usual time for the main service, in 15-minute increments.

Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (List separately in addition to code for primary procedure.)

Example 1: A physician spends 75 minutes with a patient during a home visit. The primary service code, 99345 (for a new patient home visit typically requiring 50-70 minutes) is billed, along with G0318 to account for the additional 5 minutes., A nurse practitioner spends an hour and a half providing a home visit for an established patient, requiring significant care coordination and communication with family members. The primary service code is billed, with G0318 added to account for the prolonged time spent beyond the typical time for a 99350., A physician assistant spends an hour with a new patient during a home visit involving wound care and patient education. Due to the complexity of the wound care, additional time was spent above the typical time allotted for a 99345. G0318 is used to bill for the additional time.

Documentation should support the medical necessity of the prolonged service time, specifying the total time spent on the date of service for both direct and indirect patient contact related to the primary E/M service, including a description of the activities performed during the prolonged service time.

** Code G0318 is not limited to time spent on the date of the encounter, but includes time spent on the same day of the encounter as well as any time spent within three days prior to the service or within seven days after the service.