Reminder: Guidance only applies to CPT® codes 99202-99215

Summary of MDM Chart and Changes

  • Code 99201 has been deleted
  • Code 99211 does not have specific MDM elements
  • May not report prolonged services if reporting solely based on MDM
  • 3 elements have not changed from previous MDM
    • Number and Complexity of Problems Addressed (Problems)
    • Amount and/or Complexity of Data to be Reviewed and Analyzed (Data)
    • Risk
  • Number and Complexity of Problems Addressed
    • Definitions added for complexity of problems to more appropriately classify conditions being diagnosed
  • Amount and/or Complexity of Data to be Reviewed and Analyzed
    • Definitions added under Data to better help identify what qualifies for data sources
    • Independent historian added (including parents)
    • Quantification of tests ordered and/or reviewed
  • Risk
    • Definitions added
    • Social determinants of health now included under Risk (when identified and documented)

2021 MDM Charts