09/18/2026
E/M MDM vs. Time: Which Should You Use?
When selecting an E/M level, MDM is not automatically preferred over time—and time is not automatically preferred over MDM.
The goal is to choose the method that supports the higher, fully documented level of service.
Key points to remember:
• CPT guidelines do not establish a hierarchy between MDM and time.
• Even if the provider indicates a level based on MDM, the coder may select the E/M code based on total time when the documentation supports it.
• When coding based on time, the provider must clearly document the total qualifying time spent on the date of the encounter.
• Total time can include qualifying face-to-face and non-face-to-face activities performed on that date.
• If time is not documented or does not support a higher level, select the service based on MDM.
Bottom line: Don’t automatically default to one method. Review the documentation and determine whether MDM or time supports the appropriate E/M level.
