1. What is E/M Level Calculation?

The E/M (Evaluation and Management) level determines the complexity of patient encounters for billing purposes. The 2025 guidelines allow level determination based on either Medical Decision Making (MDM) or Time.

2. How Does the Calculator Work?

The calculator uses the following logic:

Where:

• MDM Level — Determined by complexity of medical decision making (1-5)
• Time Level — Based on total encounter time:
  • Level 1: <40 minutes
  • Level 2: 40-59 minutes
  • Level 3: 60-79 minutes
  • Level 4: 80-109 minutes
  • Level 5: ≥110 minutes

3. Importance of Accurate E/M Level

Details: Proper E/M level determination ensures appropriate reimbursement and compliance with billing regulations while accurately reflecting the work performed.

4. Using the Calculator

Tips: Select the appropriate MDM level (1-5) and enter total encounter time in minutes. The calculator will determine the final E/M level based on whichever method yields the higher level.

5. Frequently Asked Questions (FAQ)

Q1: Can I use either MDM or Time for any encounter?
A: Yes, as of 2025 guidelines, you can use whichever method is most favorable for the encounter.

Q2: What time components are included?
A: Total time includes face-to-face and non-face-to-face time spent on the day of the encounter.

Q3: How is MDM level determined?
A: MDM is based on three components: number/complexity of problems, amount/complexity of data reviewed, and risk of complications.

Q4: Are there different time thresholds for new vs established patients?
A: No, the 2025 guidelines use the same time thresholds for all patient types.

Q5: What if MDM and Time suggest different levels?
A: You may use whichever method results in the higher level, as this calculator automatically does.