UNDERSTAND THE REASONING
Office E/M Code Guide: Time or MDM
Work through new or established outpatient E/M code selection using documented medical decision making or qualifying encounter-date time.
Open the guided E/M tool ↗Free to use. No card required.
How it works
- Choose the patient relationship and selection method: medical decision making or qualifying time.
- For MDM, assess problems addressed, eligible data, and management risk. For time, enter eligible physician or QHP minutes on the date of service.
- Check the source rules and documentation before reviewing the suggested base code.
Two routes, one documentation requirement
For an established outpatient visit, 99214 can be supported by moderate MDM or by meeting the 30-minute qualifying-time threshold. Medication management alone does not determine the overall MDM level. The guide explains its result and links to code details.
What to know before you start
Office/outpatient visits only. Does not determine medical necessity, modifiers, prolonged services, inpatient codes, or 99211. No patient text is requested, and selections are not saved.
Source: CMS E/M guide. Content checked September 2026.
Common questions
Does a longer note support a higher code?
No. Use the actual documented work and the applicable time or MDM criteria.
Can this replace a coding review?
No. It is an educational aid. Verify current payer rules and the encounter documentation before submission.