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Evaluation and Management Services Information Center

Welcome to the Evaluation and Management Services Information Center! Here you will find helpful resources to assist you with Evaluation and Management Services, appropriate medical record documentation and coding.



CMS Evaluation and Management Manuals, Guidelines, Education and General Information:

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CMS Fact Sheet:

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Coding References Links:

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Cahaba Website:


Reasonable and Medically Necessary Services and Documentation Requirements:

Medical Review:

  • Cahaba Medical Review Home Page – The goal of the contractor’s MR Program is to participate in reducing the contractor’s claims payment error rate (CERT) by identifying, through analysis of data and evaluation of other information, program vulnerabilities concerning coverage and coding made by individual providers and by taking the necessary action to prevent and address the identified vulnerabilities.
  • CMS Article Database – This section represents articles published by the Medical Review Department in an effort to educate the provider community on proper coding and billing related to Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and/or from issues noted in the Carrier’s claims and probe review activities.

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Cahaba GBA Medical Review Articles:

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Coverage Determinations:

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Evaluation and Management Documentation Tools:

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