Evaluation and management (E/M) level
Updated September 30, 2026
Definition
The billing code for a visit with a doctor or other clinician, like an office visit. Its level reflects how complex the visit was or how much time it took.
Evaluation and management (E/M) is the billing name for a visit where a clinician checks on you and decides on care. Office visits for established patients use codes 99211 through 99215. A higher number means a higher level.
For most visits, the clinician picks the level based on how complex the medical decisions were or how much time they spent that day. You'll see the code on an itemized bill or your explanation of benefits (EOB), often next to words like "office visit."
For example, say your plan allows $110 for a level 3 visit and $160 for a level 4 visit. With 20% coinsurance, you'd owe $22 for the first and $32 for the second. If a short, simple visit shows a high level, it's fair to ask the billing office how the level was chosen. Mistakes happen, and a corrected code can lower your share. See common medical billing errors.
Related terms
Guides that use this term
- Guide12 common medical billing errors and how to spot themDuplicate charges, wrong codes, missing insurance discounts, and more. Use this checklist of 12 common medical billing errors, then learn how to fix them.
- GuideHow to get an itemized hospital bill (script and letter)Your hospital bill shows only totals? Here's how to get an itemized bill, with a phone script, a short letter, your rights, and what to check first.
Sources
- Evaluation and management services (MLN006764), Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
- Evaluation & management services (Medicare provider compliance tips), Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.