If a provider sees a new patient and performs a comprehensive history, does the comprehensive history warrant submitting a higher level service?

It depends. The level of evaluation and management (E/M) service is dependent on three key components (history, examination and medical decision making). Performance and documentation of one component (e.g., history) at the highest level does not necessarily mean that the encounter in its entirety qualifies for the highest level of E/M service.


Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bid Program

JM Part A

JM Part B

JM Home Health & Hospice


Railroad Medicare Providers

Railroad Medicare Beneficiaries

National Supplier Clearinghouse