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The E/M changes to the office/outpatient codes from 2021 and the new changes to other non-office/outpatient codes effective for 2023 were made with the following guided principals in mind: Decrease administrative burden of documentation and coding align CPT and CMS whenever possible Decrease the need for audits Decrease unnecessary documentation in the medical record that is not needed for patient care Ensure that payment for E/M is resource-based and that there is no direct goal for payment redistribution between specialties Highlights of major changes include: Removal of documentation requirements for History and Exam for the purpose of code selection Document what is necessary for patient care Medical Decision Making (MDM) or time are the only determinants of code level Time based billing Number of minutes required for each code has changed Total time on date of encounter can be counted Counseling and coordination of care time is no longer a factor Observation codes have been deleted Inpatient codes now include observation services as well Place of Service distinction will still exist Inpatient and Observation Care Services Revision to guidelines Revision of codes 99221-99223, 99231-99236, 99238-99239 to include observation care services Deletion of codes 99217-99220 and 99224-99226 Consultations Revision to guidelines Revision of codes 99242-99245 and 99252-99255 Deletion of codes 99241 and 99251 Emergency Department Services Revision to guidelines Revision of codes 99281-99285 Nursing Facility Services Revision of codes 99304-99310 Deletion of code 99318 Home and Residence Services Revision to guidelines Revision of codes 99341, 99342, 99344, 99345, and 99347-99350 Deletion of codes 99324-99328, 99334-99337, 99339, 99340, and 99343 Prolonged Services Revision to guidelines Creation of 99418 for prolonged services in the inpatient and observation setting CMS created its own set of HCPCS codes to be used to report prolonged services based on different timeframes than CPT (G0316, G0317, G0318) Revision of codes 99417 and 99483 Deletion of codes 99345 and 99355-99357 New Artificial Intelligence (AI) Taxonomy Appendix Appendix S was newly added to CPT for the 2023 edition to report Artificial Intelligence Taxonomy for Medical Services and Procedures