E/M Code and Guideline Changes 2023


The AMA’s CPT Evaluation and Management (E/M) Code and Guideline Changes, effective January 1, 2023.

Full Description

The AMA’s CPT Evaluation and Management (E/M) Code and Guideline Changes went into effective January 1, 2023. Specific attention should be paid to the new guidelines for Services Reported Separately on page 5. While there are few changes that affect Urgent Care, it is best practice to have the new guidelines on hand for the current year.



The medical coding guidelines were updated on January 1, 2023 and there were some changes affecting urgent care. There were a few definitions added to the Elements of Medical Decision Making grid. Here are the major changes:


Stable, acute illness: A problem that is new or recent for which treatment has been initiated. The patient is improved and, while resolution may not be complete, is stable with respect to this condition.


Acute, uncomplicated illness or injury requiring hospital inpatient or observation level care: A recent or new short-term problem with low risk of morbidity for which treatment is required. There is little to no risk of mortality with treatment, and full recovery without functional impairment is expected. The treatment required is delivered in a hospital inpatient or observation level setting.


Parenteral Controlled Substances was added to the Risk of Complications and/or Morbidity or Mortality of Patient Management in the high-risk category.

Additional information




The American Medical Association


CPT Editorial Panel


42 pages