Office/Outpatient E/M Visit Coding Changes

New Guidelines, New Codes

Physicians and other practitioners who are paid under the Medicare Physician Fee Schedule (MPFS) bill for common office or other outpatient visits for evaluation and management (E/M) services using a set of Current Procedural Terminology (CPT)* codes that distinguish visits based on the level of complexity, site of service, and whether the patient is new (CPT codes 99201-99205) or established (CPT codes 99211-99215).

For the first time since it was introduced in 1992, the office/outpatient E/M CPT code set has been extensively revised, including the addition of a new code to report incremental time associated with prolonged office or other outpatient services.

Effective January 1, 2021, new reporting guidelines were implemented and code selection for office/outpatient E/M services is based on:

Download E/M Coding Guidelines

CPT Coding Courses

Learn more about opportunities for surgeons and their staff to attend a CPT coding course and sharpen coding skills to maximize reimbursement.

Office/Outpatient E/M Codes

See a table that highlights the changes to the office/outpatient E/M code descriptors.

Guidelines for E/M Reporting

Look at the major differences in reporting guidelines for office/outpatient E/M visits.

History and Examination

Learn how to document H&P for office/outpatient E/M services.

Time

Take a look at the changes in time reporting requirements for office/outpatient E/M codes.

Medical Decision Making

Learn about the levels and elements of medical decision making.

Frequently Asked Questions

You may have many questions about MDM, time and how to determine the level of an office/outpatient E/M visit. Find your answers here.

Webinars

Our webinars show how surgeons should use office/outpatient E/M coding guidelines to properly report such services and avoid claims denials.