AMA Announces the Evaluation and Management Changes for 2023

2023 Summary of Revisions to the E/M Code Descriptors and Guidelines Effective January 1, 2023

Inpatient and observation care services

• Deletion of observation CPT codes (99217-99220, 99224-99226) and merged into the existing hospital care CPT codes (99221-99223, 99221-99233, 99238-99239).
• Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.

Consultations

• Deletion of confusing guidelines, including the definition of “transfer of care.”
• Deletion of lowest level office (99241) and inpatient (99251) consultation codes to align with four levels of MDM.

Emergency department services

• Maintained the existing principle that time cannot be used as a key criterion for code level selection.
• Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.

Nursing facility services

• Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.
• Revision to nursing facility guidelines with new definition of “multiple morbidities requiring intensive management,” to be considered at the high-level MDM for initial nursing facility care.
• Deletion of code 99318 (annual nursing facility assessment). This existing service will be reported through the subsequent nursing facility care services (99307-99310).

Home and residence services

• Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.
• The domiciliary or rest home CPT codes (99234-99340) were deleted and merged with the existing home visit CPT codes (99341-99350).

Prolonged services

• Deletion of direct patient contact prolonged service codes (99354-99357). These services will now be reported through either the new code, created in 2021, office prolonged service code (99417), the new inpatient or observation or nursing facility service code (993X0).
• Creation of a new code (993X0) to be analogous to the office visit prolonged services code (99417). This new code is to be used with the inpatient or observation or nursing facility services.