Evaluation and management services
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Spotlight
- Advanced primary care management services: Get information about billing Medicare
- CMS issued the CY 2025 physician fee schedule (PFS) final rule that announces policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues. See a summary of key provisions effective January 1.
- CMS issued MM13473 - How to use the office and outpatient evaluation and management visit complexity add-on code G2211
- CMS answers - FAQs about office / outpatient E/M visit complexity add-on HCPCS code G2211
Self-service tools and resources
E/M interactive worksheet - use this self-service tool to calculate a suggested E/M code based on your entries that best reflects the level of E/M services performed.
Incident-to self-service tool - use this self-service tool to assist in identifying the appropriate application of incident-to requirements.
Additional incident-to resources:
- Incident-to services - view additional incident-to services information, including links to related CMS resources and references.
Coding and guidelines
- CMS evaluation and management guide
- CMS IOM Pub. 100-04, Chapter 12, section 30.6 - E/M service codes
- AMA's 2021 changes to office and outpatient E/M services
- AMA's 2023 changes to other E/M visits
- CPT E/M office revisions - Medical decision making (MDM)
- CMS evaluation and management visits: This page contains guidance regarding documentation and payment under the Medicare Physician Fee Schedule for evaluation and management (E/M) visits.
Care management services
Care management services are covered under the Medicare program. View information regarding care management services, including links to related CMS resources and references.
Additional resources
Find helpful tips through our Understanding E/M and Understanding E/M office or other outpatient services articles.
E/M services documentation checklist: This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for E/M services
Visit the specialty / services FAQs for additional information.