2023 E/M Changes: What’s Coming?

Why This Topic Matters

The 2023 changes affect many commonly used E/M services and introduce updates that can influence documentation, education, auditing, and payer policy alignment. Understanding the scope of the changes helps practices prepare before the effective date and reduce compliance risk.

Article Sections

1. Overview of Changes

   Introduces the broad scope of the 2023 E/M revisions and the general shift in guideline structure. Summarizes the overall areas affected across the E/M section.

2. Deletions

   Lists the E/M service categories and code groupings that are removed as of the effective date. Provides a high-level view of which portions of the code set are being retired.

3. Revisions

   Identifies the E/M categories and code groupings that are being updated for 2023. Describes the types of services impacted by the revisions.

4. Additions

   Describes new E/M reporting elements being introduced for 2023. Covers the addition of prolonged service reporting in the inpatient or observation setting.

5. Definitions

   Explains that several terminology updates accompany the guideline changes. Notes that new and revised definitions were added to support the expanded E/M structure.

6. New Definitions

   Reviews new terminology added to support the updated E/M framework. Places the definitions in the context of the broader guideline changes.

7. New Additions to the MDM Table

   Summarizes updates to the medical decision making table associated with the revised guidelines. Covers changes tied to problem complexity and risk categories.

8. CPT vs CMS

   Discusses differences between CPT guidance and CMS policy for same-day E/M reporting scenarios. Highlights the need to understand payer-specific interpretation of the updated rules.

9. Putting the Changes into Action in the Practice

   Focuses on implementation planning for practices adapting to the 2023 E/M changes. Covers education, workflow preparation, and template review.

10. Education

    Addresses training needs for clinicians and coding staff. Emphasizes preparing users to document and apply the updated E/M framework.

11. Templates

    Discusses reviewing encounter templates to align documentation practices with the revised guidelines. Focuses on reducing outdated note structures and improving efficiency.