*Please refer to Reimbursement Policy RP-063 for additional information related to Consultation Services.
Except for Emergency Department codes (99281–99285), providers may choose the appropriate E/M level of care based on either Time or Medical Decision Making (MDM). Emergency Department codes (99281–99285) use only MDM to determine level of care.
Please see the Documentation Guidelines for E/M Services 2023 for additional details on how to correctly report these services. To access the 2023 Documentation Guidelines — as well as 2023 Auditor’s Scoring Worksheets and a revised list of frequently asked questions — visit the Provider Resource Center (PRC).
Once there, select CLAIMS, PAYMENT & REIMBURSEMENT from the left menu, click Documentation Guidelines For Evaluation And Management Services, and then go to 2023 RESOURCE LINKS on that page.