99355 CPT Code: Deleted — Use 99417/G2212

• CPT Codes
• 99355

99355 CPT Code: Deleted — Use 99417/G2212

CPT code 99355 was deleted in the CPT 2023 restructure. Learn the successor codes (99418 and G2212) and how to handle legacy claims.

Quick Reference

Code

99355

Code System

CPT

Category

CPT Codes

Published

Mar 4, 2026

Updated

Jun 13, 2026

Reading Time

5 min

CPT® is a registered trademark of the American Medical Association. All CPT code descriptions on this page are paraphrased in original wording; consult the current CPT® codebook published by the AMA for authoritative descriptors.

CPT 99355: Deleted Code — What Behavioral Health Providers Need to Know

CPT code 99355 was deleted effective January 1, 2023. If you are billing this code for services rendered in 2023 or later, those claims will be denied. This page explains what happened, which codes replaced 99355, how to handle legacy claims, and what the new prolonged-service framework looks like for behavioral health providers.

This page’s sibling, CPT 99354, was deleted at the same time and for the same reason — the entire pre-2023 prolonged-service pair (99354 + 99355) was retired as part of a CPT restructure that redesigned how outpatient prolonged services are reported.

Why 99355 Was Deleted

The American Medical Association deleted both 99354 and 99355 in the CPT 2023 code set as part of a broader realignment of outpatient evaluation and management prolonged-service reporting. The prior framework required a two-code sequence (99354 for the first hour, 99355 for each additional 30 minutes) that created billing complexity and generated frequent errors. The 2023 restructure replaced that system with a simpler framework built on 15-minute increments and tighter integration with the E&M time-based selection model introduced in 2021.

The deletion affected outpatient and office-setting prolonged services. Inpatient prolonged services (the former 99356 and 99357) were separately addressed in the restructure.

Successor Codes (Effective January 1, 2023)

For non-Medicare payers — outpatient or office-based:

For Medicare outpatient claims:

Key differences from the old 99354/99355 system:

The shift from 30-minute to 15-minute increments means unit counts differ under the new system compared to the old one. Do not assume that a one-unit 99355 encounter maps to a one-unit 99418 encounter — recalculate from scratch using the new time thresholds.

• CPT 99417 — Prolonged outpatient evaluation and management service, first 15 minutes beyond the maximum time of the primary E&M code on the same date (add-on). This is the first unit of the new framework.
• CPT 99418 — Each additional 15 minutes beyond CPT 99417 (add-on). Report additional units as the encounter extends.

• G2212 — Prolonged office or other outpatient evaluation and management service beyond the maximum time of the primary E&M on the same date, each additional 15 minutes (add-on). Medicare does not recognize CPT 99417 for outpatient prolonged services; use G2212 instead.

Replacement Code Crosswalk

Use this crosswalk for context when reviewing pre-2023 claims or payer correspondence. Do not use it to mechanically convert new claims — always apply the correct 2023+ rules to current services.

These are approximate equivalents based on time mapping, not validated crosswalk tables. Confirm each payer’s current rules before applying.

Legacy Claim and Recoupment Handling

If you receive a recoupment demand or payer inquiry referencing CPT 99355 for dates of service before January 1, 2023, the code was valid at that time. Respond using the documentation standards in effect during the service period:

If you have claims with 2023 or later dates of service billed with 99355, those should be voided and rebilled with the appropriate successor code. Review your billing system’s code libraries to confirm 99355 is flagged as deleted for post-2022 dates of service.

• The claim should have included a qualifying primary E&M or psychotherapy code, followed by 99354 (first hour), followed by 99355 for each additional 30-minute increment.
• Documentation should show exact start and stop times, direct face-to-face time, time beyond the typical duration of the primary code, and medical necessity for the extended encounter.
• Each 99355 unit required at least 15 minutes of direct face-to-face time beyond the previous code threshold (the midpoint rule).

Historical Context

Before the 2023 restructure, CPT 99354 and 99355 were the primary tools for capturing prolonged outpatient face-to-face time. In behavioral health, they were particularly relevant for extended psychiatric evaluations, multi-hour crisis stabilizations, comprehensive intake assessments, and complex family therapy sessions. The codes required direct face-to-face time and could not count non-face-to-face activities such as chart review or documentation.

Behavioral health providers who previously relied on 99354 and 99355 for revenue capture from extended sessions now use 99417/99418 (non-Medicare) or G2212 (Medicare) under the same clinical scenarios, but with 15-minute instead of 30-minute billing increments. The compliance principles — accurate time documentation, established medical necessity, qualifying primary code selection — remain the same.

Compliance Note

Billing 99355 for current dates of service is a billing error, not simply a code substitution question. If your EHR or billing system still includes 99355 as an active code selection, update your code libraries. Payers that detect 99355 on post-2022 claims will deny them; some may flag repeated submission of deleted codes for review. If you discover a pattern of post-2022 99355 submissions, evaluate whether a voluntary disclosure and rebilling is appropriate.

Related Billing Codes

• 99214
• 99215
• 99354
• 99396
• 99406
• 99407

Reference tables

Common questions

Official sources

No publisher link is recorded for this topic yet. Confirm the requirement with the governing payer, state agency or accreditor before relying on it — see the primary source directory.