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E/M Documentation Guidelines, 2021 to Present

Member Tool - November 10, 2020

Coding & Documentation

Billing & Collections


Getting paid for some of the most routine outpatient office visits became a new challenge on Jan. 1, 2021, when guideline and code descriptor changes for E/M services — previously announced by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) — take effect.

Specifically, office or other outpatient E/M codes 99202 through 99215 are being updated along with the elimination of code 99201 (due to low utilization).

Article: 2021 E/M changes explained

This member-benefit guide helps your practice and medical coders understand changes to medical decision making for outpatient E/M codes, effective Jan. 1, 2021.

This resource is part of the 2022 Medical Coding, Billing and Auditing Toolkit.

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About the Author

Veronica Bradley
Veronica Bradley CPC, CPMA
Senior Industry Advisor MGMA Englewood, CO

Veronica Bradley, CPC, CPMA, is a Senior Industry Advisor with MGMA and is CPC and CPMA certified. She has over 20 years’ experience in medical coding and auditing in various specialties. She is also well-versed hierarchical condition category and risk adjustment coding. Other areas of expertise include evaluation and management, procedural coding, Medicare reimbursement, and other critical factors in coding and auditing. Veronica has worked in private practice, group practices, academic school of medicine and hospitals. She focuses on educating based coding guidelines and code capture accuracy for all medical practice staff and believes coders must build rapport with healthcare providers to ensure healthy communication as necessary in the charge capture process.

Veronica received a bachelor’s degree from Regis University in Denver, Colorado in Health Information Management with a minor in Healthcare Administration. In her free time, Veronica appreciates spending time with her family enjoying the beautiful Colorado scenery.


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