CMS poised to accept most 2023 E/M revisions, with a few asterisks

Why This Topic Matters

These updates affect how common E/M services are reported and billed across multiple care settings, including Medicare-specific differences that can change claim handling and reimbursement. The article helps readers identify where policy alignment exists and where Medicare retains unique requirements.

Article Sections

1. CMS and AMA alignment and differences

   Overview of the updated E/M framework for facility and residential settings, including areas where Medicare follows the broader revisions and where CMS retains its own policies. The section also addresses specialty-related distinctions and practitioner classification.

2. Observation/inpatient-specific policies

   Discussion of policies applying to observation and inpatient services, including same-stay treatment, place-of-service issues, and how bundled scenarios are handled under Medicare.

3. Nursing facility notes

   Coverage of Medicare’s nursing facility assessment policies, including timing-related considerations, same-day service handling, and the treatment of comprehensive assessment visits.

4. CMS bids grudging goodbye to 99318

   Review of Medicare’s position on the annual nursing facility assessment code and the implications of its removal for future reporting practices.

5. Medicare OK with merged residential codes

   Summary of changes affecting home and residential service code groupings and the shift to revised code structures for those settings.