2023 E/M Coding Updates

On January 1, 2023, several new updates to the Evaluation and Management (E/M) section of the CPT code book will take effect. 25 codes are being deleted, there are revisions to five different coding categories’ introductory guidelines and prolonged services received a complete revision.

The codes that are being deleted are as follows:

  • Consultation codes 99214 – 99251
  • Prolonged service codes 99354 – 99357
  • Nursing facility service code 99318
  • Hospital observation codes 99217 – 99220 and 99224 – 99226
  • Home or resident service code 99343
  • Domiciliary, rest home, or custodial care service codes 99324 – 99328, 99334 – 99337, 99339 and 99340

A new coding section will be made available for hospital inpatient, observation care and nursing facility codes for both new and established patients. It will be titled, “Initial and Subsequent Services.” The American Medical Association (AMA) extended the framework for the 2021 E/M updates to the remaining E/M codes. For the categories below, the level of E/M service may be selected based on medical decision-making time:

  • Hospital inpatient and observation care
  • Emergency department visits/services
  • Consultation services
  • Nursing facility services
  • Home/residence services

Three elements will be the factors during code selection for these categories: the number of and complexity of problems addressed during the encounter, the amount of and/or complexity of data that needs to be reviewed and the risk of complications, morbidity or mortality.

For hospital inpatient and observation care coding, there are two sets of codes. The first is used for when a patient is admitted and discharged on the same calendar day (99234 – 99236) and the other set is for patients stay longer than a single calendar day (99221 – 99223 for initial service, 99231 – 99233 for subsequent visits and 99238 – 99239 for discharge services).

For a full breakdown of the 2023 E/M coding updates, please visit codingintel.com or click here.





About PGM

Physicians Group Management (PGM) is one of the fastest-growing medical billing companies in the United States.  For over 35 years, PGM has been providing medical billing and practice management services and software to physicians, healthcare facilities, and laboratories.  PGM’s current client base encompasses the full spectrum of medical specialties, including Internal Medicine, Dermatology, Plastic & Reconstructive Surgery, Pathology, EMS & Ambulatory Services, Cardiology, Nephrology, Urology, Pain Management, OB/GYN, Gastroenterology, Independent Laboratory, General Surgery, Vascular Surgery, Plastic Surgery, and many more.  PGM’s medical billing and practice management solutions include:                –