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E/M (Evaluation and management)

Modified: 4/8/2025
Telehealth services substitute for an in-person visits and involve two-way, interactive technology permitting communication between the practitioner and patient. This article was recently updated to incorporate the most current Medicare requirements included in the CMS Telehealth & Remote Patient Monitoring MLN Booklet.
Modified: 3/12/2025
CMS has new guidelines for critical care services effective January 1, 2022. These updates were implemented February 15, and impacted existing billing and coding processes.
Modified: 2/11/2025
CMS published a new FAQ document on calendar year 2025 telehealth claims processing. Take time to review the latest information.
Modified: 2/7/2025
View these available resources for guidance on E/M services.
Modified: 2/5/2025
CMS has new guidelines for teaching physicians effective January 1, 2022. These updates were implemented February 15, and addressed services in certain primary care centers along with selection of office/outpatient time-based codes.
Modified: 1/15/2025
Care management services are covered under the Medicare program. View information regarding care management services, including links to related CMS resources and references.
Modified: 1/10/2025
Effective January 1, 2023, updates were made impacting evaluation and management (E/M) billing for home or residence services.
Modified: 1/3/2025
Modified: 7/3/2024
Learn how to take advantage of the features of our exclusive E/M interactive worksheet and find the code that best represents the level of evaluation and management services (E/M) furnished during a patient’s visit.
Modified: 7/1/2024
CMS addresses chronic care management guidelines and how practitioners can offer access to care and care continuity, with reference to communication methods such as secure messaging, secure web, or other methods.
Modified: 6/1/2024
Learn more about billing Medicare for prolonged office and other outpatient E/M services that exceed the maximum time by at least 15 minutes on the date of service.
Modified: 5/18/2024
Effective January 1, 2023, changes were made to hospital inpatient or observation discharge day management codes. Review this article for tips on proper code submissions.
Modified: 5/4/2024
Learn more about billing Medicare for prolonged hospital inpatient or observation care E/M services exceeding the maximum time by at least 15 minutes on the date of service.
Modified: 5/1/2024
This is a central location for incident-to services information, including links to related CMS resources and references. General information regarding the Medicare program can be found using the topics on your left navigation bar. Please subscribe to our eNews to stay current with Medicare.
Modified: 4/14/2024
Medicare pays for services and supplies that are furnished incident to a physician’s or other practitioner’s services, are commonly included in the physician’s or practitioner’s bills, and for which payment is not made under a separate benefit category.
Modified: 4/13/2024
Physician or allowed practitioner services involving certification and recertification of Medicare-covered home health services may be separately coded and reimbursed.
Modified: 4/13/2024
Care plan oversight (CPO) is supervision of patients under care of home health agencies or hospices that require complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication with other health professionals not employed in the same practice who are involved in the patient’s care, integration of new information into the care plan, and/or adjustment of medical therapy.
Modified: 4/12/2024
Avoid claim rejects. If you bill E/M codes within the CPT code range 99202-99239, do not report more than one unit per date of service.
Modified: 4/11/2024
Nursing facilities include skilled nursing facilities, psychiatric residential treatment centers, and immediate care facilities for individuals with intellectual disabilities.
Modified: 4/11/2024
This is a central location for locating supervising physician in teaching setting information, including links to related CMS resources and references.
Modified: 4/11/2024
Scribed services are those in which the physician utilizes the services of ancillary personnel to document/record the work performed by that physician, in either an office and other outpatient or a facility setting.
Modified: 4/10/2024
Our E/M interactive worksheet has been upgraded to assist you with verifying proper code selection for office and “other” E/M visits for 2023 and beyond. Take a look.
Modified: 4/10/2024
Observation care is a well-defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment, furnished while a decision is being made regarding whether a patient will require further treatment as a hospital inpatient or if they are able to be discharged from the observation care.
Modified: 3/19/2024
Learn more about billing Medicare for prolonged home or residence E/M services that exceed the maximum time by at least 15 minutes on the date of service.
Modified: 2/18/2024
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.