Evaluation and Management Coding

Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.

[1] E/M standards and guidelines were established by Congress in 1995[2] and revised in 1997.

[3] It has been adopted by private health insurance companies as the standard guidelines for determining type and severity of patient conditions.

E/M codes are based on the Current Procedural Terminology (CPT) codes established by the American Medical Association (AMA).

In 2010, new codes were added to the E/M Coding set, for prolonged services without direct face-to-face contact.