Documentation Guidelines for Evaluation and Management Services

What’s New In 2023

In alignment with the Office and Outpatient Evaluation and Management (E/M) Coding Guidelines changes that were effective January 1, 2021, the following code sets were revised effective January 1, 2023:

  • Non-Office E/M codes (99221-99223, 99231-99239)
  • Consultation codes (99242-99245, 99252-99255)*
  • Emergency Department codes (99281-99285)
  • Nursing Facility Service codes (99304-99310, 99315, 99316)
  • Home or Residence Service codes (99341, 99342, 99344, 99345, 99347-99350)

Except for Emergency Department codes (99281-99285), providers may choose the appropriate E/M level of care based on either Time or Medical Decision Making (MDM). Emergency Department codes (99281-99285) use only MDM to determine level of care.

Please see the Documentation Guidelines for E/M Services 2023 for additional details on how to correctly report these services.


2023 Resource links

*Please refer to Reimbursement Policy RP-063 for additional information related to Consultation Services.


2021 Office And Outpatient Evaluation And Management Resources


Prior To 2021 Evaluation And Management Resources

(Note: These guidelines will not be in effect for any E/M services as of January 1, 2023.)

Below you will find the Documentation Guidelines that were effective prior to 2021 for office and outpatient E/M services and effective prior to 2023 for all other E/M services:

Last updated on 3/9/2023 9:51:24 AM


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