How it works
E/M codes cover office visits, hospital care, consultations, emergency department visits, nursing facility care and more. Office visits use 99202–99205 for new patients and 99211–99215 for established patients. Since 2021, office visit levels are chosen by medical decision making or by the clinician’s total time on the date of the encounter, not by counting history and exam elements; in 2023 the same approach was extended to most other E/M settings.
Why it matters
E/M services are the most frequently billed codes in many practices. Under-coding loses revenue on every visit; over-coding creates audit risk. Level choices should follow the documentation, and patterns are worth comparing across providers.
Example
An established patient with two stable chronic illnesses has a medication adjusted. That supports moderate medical decision making, typically 99214. See medical coding.