Changes to 2021 E & M Codes


     After nearly 30 years, CMS is making significant changes to E/M (Evaluation & Management) codes beginning January 1, 2021.  The goal is to reduce the burden of documenting/charting as extensively on providers (Yahoo!).


According to AMA, some of the benefits include:

  • Administrative - You will no longer need to re-document the patient's chief complaint or history.  Only items that have occurred since the last visit need to be documented.
  • Simplify Code Selection - You can select MDM (Medical Decision Making) or Time spent as the basis for your code selection.
  • Payment Collapse - There will be 2 payment levels for each of the 5 E/M codes.
  • Additional Code - An additional code will be available for "higher complexity" specialties.


    More info will be coming as we get closer, but listed below are the major revisions that will be coming effective January 1, 2021, according to AMA.


  • Extensive E/M guideline additions, revisions and restructuring
  • Deletion of code 99201 and revision of codes 99202-99215
    • Codes 99201 and 99202 currently both require straightforward MDM
  • Addition of a shorter 15-min prolonged service code
  • Components for code selection:
    • Medically appropriate history and/or exam
    • Choose your reporting pathway
      • MDM or
      • Total time on the date of the encounter









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