This issue of AAP Pediatric Coding Newsletter continues our series of articles on changes to office and other outpatient evaluation and management (E/M) codes that will be implemented for services provided on and after January 1, 2021. These changes only affect codes 99201–99205 and 99211–99215 in 2021. This issue provides an overview of the planned changes related to selection of the level of medical decision-making (MDM).

As noted in previous articles, code selection for office E/M services will be based on MDM or time for services provided in 2021. Currently, the level of MDM is often determined using a complex points system developed by the Marshfield Clinic decades ago. (See “A Review of the Marshfield Clinic Medical Decision-making Tool” in the January 2018 AAP Pediatric Coding Newsletter online at

Beginning in 2021, selecting the level of MDM for an office E/M service will be more straightforward. A...

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