ED E/M Level Calculator — 2023 MDM (99281–99285)

Clinician CadenceED E/M Level — 2023 MDM

1. Problems addressed

Number & complexity of problems addressed at the encounter — pick the single highest-complexity descriptor that applies.

One self-limited or minor problemStraightforwardTwo+ self-limited/minor problems · or 1 stable chronic illness · or 1 acute uncomplicated illness or injuryLow1+ chronic illness with exacerbation/progression or treatment side effects · or 2+ stable chronic illnesses · or 1 undiagnosed new problem with uncertain prognosis · or 1 acute illness with systemic symptoms · or 1 acute complicated injuryModerate1+ chronic illness with severe exacerbation/progression or side effects · or an acute or chronic illness/injury that poses a threat to life or bodily functionHigh

2. Data reviewed

Amount & complexity of data — count each unique test/note once. The tool applies the 2023 category rules (Limited needs ≥ 2 data points; Moderate needs ≥ 3, or an independent interpretation, or an external discussion).

Unique tests ordered0

Unique test results reviewed0

Prior external notes reviewed (per source)0

Independent historian (EMS, family, caregiver…)Independent interpretation of a test (by you, performed by another physician)Discussion of management with an external physician/QHP

3. Risk

Risk of complications and/or morbidity/mortality of patient management — pick the single highest applicable descriptor.

Minimal risk — reassurance, no testing or treatmentStraightforwardLow risk — e.g. over-the-counter medications, a minor low-risk procedureLowPrescription drug management · or a minor surgery with patient/procedure risk factors · or elective major surgery without risk factors · or diagnosis/treatment significantly limited by social determinants of healthModerateDecision regarding hospitalization or escalation of care · or parenteral controlled substances · or drug therapy needing intensive toxicity monitoring · or emergency major surgery · or a decision to de-escalate care / DNRHigh

4. Critical care / special cases

Optional. Critical care is time-based and supersedes the MDM level.

Critically ill/injured patient with physician-delivered critical careVisit did not require a physician/QHP (nursing-only) → 99281

Documentation & education support for licensed clinicians only. This returns a suggested E/M level based on the public 2023 AMA Medical Decision Making framework. It is not a coding or billing determination, not a guarantee of payment, and not a substitute for a certified professional coder or the treating clinician’s judgment — the final code is theirs. CPT© is copyright the American Medical Association; descriptors here are paraphrased, not reproduced. No patient-identifying information is collected or transmitted — all computation happens in your browser.

ED E/M leveling — FAQ

How does the 2023 ED E/M level get chosen?

Since January 2023, emergency-department E/M levels (99281–99285) are selected by Medical Decision Making (MDM) alone — history and exam are no longer counted, and time is not a factor for ED codes. MDM is set by the level reached by at least two of three elements: the number and complexity of problems addressed, the amount and complexity of data reviewed, and the risk of complications/morbidity.

What do the levels map to?

99281 is a visit that may not require a physician/QHP. Otherwise: straightforward MDM → 99282, low → 99283, moderate → 99284, high → 99285. Critical care (99291/99292) is time-based and separate.

Is this a billing determination?

No. It is documentation and education support — a suggested level based on the public 2023 MDM framework. The final code is the responsibility of the treating clinician and a certified professional coder. It is not a guarantee of payment.

Is any patient information stored?

No. All computation runs in your browser — no patient-identifying fields are collected, and nothing is sent to or logged on a server.

Does it cover facility (hospital) leveling?

No. This tool is for professional (physician/QHP) E/M only, which follows a single national AMA/CMS MDM standard. Facility ED leveling uses each hospital’s own internal acuity grid and is out of scope.