Emergency Medicine E/M Coding Guide — 2023 AMA/CMS Level Selector

The 2023 Emergency Medicine Evaluation and Management (E/M) coding framework reflects the American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) updates to ED/emergency department E/M code levels (99281–99285). The 2023 revisions aligned ED coding with the office visit E/M changes (which eliminated history and physical exam as primary determinants), focusing instead on Medical Decision Making (MDM) complexity as the dominant determinant of E/M level. For ED visits, all three components — history, physical exam, and MDM — are still considered, but MDM complexity drives most encounters. Accurate E/M coding is a legal and compliance requirement under federal anti-kickback statutes and the False Claims Act.