Evaluation and Management Coding

Evaluation and management coding (commonly known as E/M coding or E&M coding) is a <a href="/facts/Medical_coding/M4YSyd0P">medical coding</a> process in support of <a href="/facts/Medical_billing/uYsolroo">medical billing</a>. Practicing health care providers in the United States must use E/M coding to be reimbursed by <a href="/facts/Medicare_(United_States)/vLKMBktB">Medicare</a>, <a href="/facts/Medicaid/ml1fNWjX">Medicaid</a> programs, or <a href="/facts/Private_insurance/06VP8I3B">private insurance</a> for patient encounters.
E/M standards and guidelines were established by Congress in 1995 and revised in 1997. It has been adopted by private <a href="/facts/Health_insurance/sGeHMbID">health insurance</a> companies as the standard guidelines for determining type and severity of patient conditions. This allows medical service providers to document and bill for reimbursement for services provided.
E/M codes are based on the <a href="/facts/Current_Procedural_Terminology/AlxoW87a">Current Procedural Terminology</a> (CPT) codes established by the <a href="/facts/American_Medical_Association/Wmfxy2xV">American Medical Association</a> (AMA).
In 2010, new codes were added to the E/M Coding set, for prolonged services without direct face-to-face contact.

Evaluation and Management Coding open-in-new

Evaluation and Management Coding