Preparing for the 2023 Evaluation & Management (E/M) Changes: Part 1

2023 Evaluation and Management Changes

The Evaluation and Management Changes we experienced in 2021 are being expanded and effective January 1, 2023 and the majority of other E/M services will also be updated. With this advanced notice, there is time to work with providers on these changes and ensure all receive adequate training and education.   

First, the E/M introductory guidelines have been updated for the following areas:

  • Hospital Inpatient and Observation Care Services (99221 – 99223, 99231 – 99239)
  • Consultations (99242 – 99245, 99252 – 99255)
  • Emergency Department Services (99281 – 99285)
  • Nursing Facility Services (99304 – 99310, 99344, 99345, 99347 – 99350)
  • Home or Residence Services (99341, 99342, 99344, 99342, 99347 – 99350)
  • Prolonged Services (99358, 99359, 99415, 99415, 993X0)

Next, below is a summary of 2023 Evaluation and Management Changes:

E/M Services:Changes Coming:
Inpatient/ObservationDeletion of Observation Codes 99217 – 99220
Revisions of Initial and Subsequent Inpatient Codes  (99221–99223 and 99231–99239)
Consultations for Office and Inpatient ServicesDeletion of consultation codes 99241 (lowest level for office consultation) and 99251 (lowest level of inpatient consultation)
Revision of Office Consultation (99242–99245)
Revision of Inpatient Consultations (99252–99255)
Emergency DepartmentRevision of Emergency Service codes (99281–99285)
Prolonged ServicesNew codes 993X0
Deletion of Prolonged Services codes 99254–99357
Revision of 99417 (Prolonged Office E/M)
Domiciliary, Rest Home or Custodial Care ServicesDeletion of codes 99324-99238, 99334-99337, 99339, and 99340
Expect a reorganization of this subsection
Home Health ServicesDeletion of 99343 (Home visit code)
Revision of 99341, 99342, 99344. 99345, 99347–99350
Nursing Facility ServicesDeletion of Nursing Facility Services (99318)
Revision of Nursing Facility Services (99304–99310, 99315, and 99316)

The next blogs will provide additional details surrounding these specific changes.

Click Here for Part 2: https://uasisolutions.com/preparing-for-the-2023-evaluation-management-e-m-changes-part-2/

References:  2023 CPT E/M descriptors and guidelines (ama-assn.org)

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