E/M Changes for 2024 for medical coders

2024 CPT codebook will have new updated coding guidelines for time in the introduction to make it clear that the mid-point concept does not apply to E/M services that have a total time threshold.

CPT 2024 has decided to remove the time ranges from both the new and established office/outpatient E/M codes and replace them with a single total time amount, which is the lowest number of minutes in the current range for each code. This time “must be met or exceeded” according to the new wording that now appears in each of the codes’ descriptors.

So, office visit codes 99202-99205 and 99212-99215 have been revised to remove the code range from each code Instead, clinicians billing based on time will have a single minimum time threshold that must be met or exceeded.

Their is no change in the code description for these codes and you will continue to bill these code as usual in 2024.

What is the change in Time in E/M?

Below table will give you a clear picture on how the time should be calculated.

CODE	2023 “total time … spent on the date of the encounter”	2024 “total time on the date of the encounter” that “must be met or exceeded”
99202	15-29	15
99203	30-44	30
99204	45-59	45
99205	60-74	60
99212	10-19	10
99213	20-29	20
99214	30-39	30
99215	40-54	40

The time description will be changed for the E/M visit codes. Below is the example;

Consider the descriptor changes for code

99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15~~-29 minutes of total time is spent on the date of the encounter~~ minutes must be met or exceeded).

99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making.

When using total time on the date of the encounter for code selection, 30~~-44 minutes of total time is spent on the date of the encounter~~ minutes must be met or exceeded).

99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making.

When using total time on the date of the encounter for code selection, 45 ~~-59 minutes of total time is spent on the date of the encounter~~ minutes must be met or exceeded).

99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making.

When using total time on the date of the encounter for code selection, 60 –~~74 minutes of total time is spent on the date of the encounter~~ minutes must be met or exceeded).

However, practices that report visits in the nursing facility setting should note the five-minute time increase for two visits. When a practice reports a visit based on time initial visit, 99306 will require 50 minutes total time and subsequent visit 99308 will require 20 minutes of total time.

The sole new addition to the E/M code set is a new add-on code, 99459 (Pelvic examination [List separately in addition to code for primary procedure]).