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in 2021 the AMA significantly revised the documentation requirements and methodology for selecting a level of service for ambulatory office encounters the 2023 revisions extend these changes to inpatient Admissions and subsequent visits inpatient consults outpatient consults emergency services in addition to others in this video I will review the changes go through the steps for selecting a level of service address time-based billing and provide examples while demonstrating the use of my level of service calculator prior to 2021 selecting a level of service required using a combination of documented history physical exam and medical decision making with the 2023 changes the documentation and number of specific history and physical exam elements has been removed for all of the encounter types an appropriate history and physical examination needs to be documented as far as what an appropriate history and physical exam is the guideline leaves this up to the provider this means that selec...