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In 2021, the AMA made significant revisions to documentation requirements and methodology for selecting a level of service for ambulatory office encounters. The 2023 revisions extend these changes to inpatient admissions, subsequent visits, inpatient consults, outpatient consults, emergency services, and more. This video reviews the changes, explains the steps for selecting a level of service, addresses time-based billing, and provides examples using a level of service calculator. Prior to 2021, selecting a level of service required a combination of documented history, physical exam, and medical decision making, but with the 2023 changes, specific history and physical exam elements have been removed for all encounter types. An appropriate history and physical examination must still be documented, with the provider determining what is appropriate.