Emergency · LIVE

2023 emergency MDM (ACEP)

Return the 2023 overall medical decision making level from caller-assigned problems, data, and risk using AMA CPT Table 1 as reprinted by ACEP (highest level at which at least 2 of 3 elements are met or exceeded).

LIVE $0.005 USDC GET /api/calc/em_mdm

Markdown: /docs/em-mdm.md · Canonical: https://magentlab.com/docs/em-mdm

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

When to use

When an agent already has the three 2023 MDM element levels (straightforward, low, moderate, or high) and needs the overall MDM the table prints. magent does not examine the patient, count tests, or assign a CPT code.

When not to use

Not a medical device.
Not a bill or CPT assignment. magent does not code the chart.
The caller assigns number and complexity of problems addressed, amount and/or complexity of data, and risk of complications and/or morbidity of management. magent does not count tests, review notes, or determine risk from the record.
Not a diagnosis.

Formula

Caller-assigned number and complexity of problems addressed, amount and/or complexity of data, and risk of complications and/or morbidity of management using the printed 2023 MDM column labels straightforward, low, moderate, and high; overall MDM is the highest level at which at least 2 of 3 elements are met or exceeded (AMA CPT 2023 Table 1 as reprinted by ACEP)

Citation

Title: CPT Evaluation and Management (E/M) Code and Guideline Changes
Authors: American Medical Association; American College of Emergency Physicians
Source: AMA CPT 2023 Table 1, Levels of Medical Decision Making, effective January 1, 2023. ACEP reprint.
DOI: none

Worked example

Low MDM (1 stable chronic illness, limited data, low risk)

Given: data=lowproblems=lowrisk=low

problems low (table: 1 stable chronic illness), data low (table: limited), risk low
2 of 3 elements meet or exceed low → overall MDM low

High MDM by 2 of 3 elements

Given: data=lowproblems=highrisk=high

problems high, data low, risk high
2 of 3 elements meet or exceed high → overall MDM high

Also searched as

emergency MDM
medical decision making
ACEP 2023 MDM
E/M MDM
2023 ED MDM
problems data risk MDM

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/em_mdm?problems=low&data=low&risk=low

Full URL: https://api.magentlab.com/api/calc/em_mdm?problems=low&data=low&risk=low

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/em_mdm?problems=low&data=low&risk=low"

Parameters

Name	Type	Required	Description
`problems`	string	required · straightforward, low, moderate, high	Caller-assigned number and complexity of problems addressed using the printed 2023 MDM column labels straightforward, low, moderate, or high (AMA CPT 2023 Table 1 as reprinted by ACEP). straightforward is the table's minimal column (1 self-limited or minor problem). low includes 1 stable chronic illness, 2 or more self-limited or minor problems, or 1 acute uncomplicated illness or injury. magent does not code the chart.
`data`	string	required · straightforward, low, moderate, high	Caller-assigned amount and/or complexity of data to be reviewed and analyzed using the printed 2023 MDM column labels straightforward, low, moderate, or high. straightforward is the table's minimal or none column; low is limited; moderate is moderate; high is extensive. magent does not count tests, notes, or independent historians.
`risk`	string	required · straightforward, low, moderate, high	Caller-assigned risk of complications and/or morbidity of management using the printed 2023 MDM column labels straightforward, low, moderate, or high (straightforward is the table's minimal risk column). magent does not determine risk from the record.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/em_mdm Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "data": "low",
      "problems": "low",
      "risk": "low"
    },
    {
      "data": "low",
      "problems": "low",
      "risk": "low"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/em_mdm",
  "items": [
    {
      "data": "low",
      "description": "Low medical decision making",
      "components": [
        {
          "value": "low",
          "factor": "problems",
          "met": true
        },
        {
          "value": "low",
          "factor": "data",
          "met": true
        },
        {
          "value": "low",
          "factor": "risk",
          "met": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "American Medical Association; American College of Emergency Physicians",
        "id": "acep-2023-em-mdm",
        "source": "AMA CPT 2023 Table 1, Levels of Medical Decision Making, effective January 1, 2023. ACEP reprint.",
        "title": "CPT Evaluation and Management (E/M) Code and Guideline Changes"
      },
      "formula": "em_mdm",
      "formula_expression": "Caller-assigned number and complexity of problems addressed, amount and/or complexity of data, and risk of complications and/or morbidity of management using the printed 2023 MDM column labels straightforward, low, moderate, and high; overall MDM is the highest level at which at least 2 of 3 elements are met or exceeded (AMA CPT 2023 Table 1 as reprinted by ACEP)",
      "risk": "low",
      "mdm": "low",
      "problems": "low"
    },
    {
      "data": "low",
      "description": "Low medical decision making",
      "components": [
        {
          "value": "low",
          "factor": "problems",
          "met": true
        },
        {
          "value": "low",
          "factor": "data",
          "met": true
        },
        {
          "value": "low",
          "factor": "risk",
          "met": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "American Medical Association; American College of Emergency Physicians",
        "id": "acep-2023-em-mdm",
        "source": "AMA CPT 2023 Table 1, Levels of Medical Decision Making, effective January 1, 2023. ACEP reprint.",
        "title": "CPT Evaluation and Management (E/M) Code and Guideline Changes"
      },
      "formula": "em_mdm",
      "formula_expression": "Caller-assigned number and complexity of problems addressed, amount and/or complexity of data, and risk of complications and/or morbidity of management using the printed 2023 MDM column labels straightforward, low, moderate, and high; overall MDM is the highest level at which at least 2 of 3 elements are met or exceeded (AMA CPT 2023 Table 1 as reprinted by ACEP)",
      "risk": "low",
      "mdm": "low",
      "problems": "low"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	em_mdm
`formula_expression`	string	Published 2023 MDM 2-of-3 met-or-exceeded rule
`problems`	string	Caller-assigned problems-addressed column: straightforward, low, moderate, or high
`data`	string	Caller-assigned data column: straightforward, low, moderate, or high
`risk`	string	Caller-assigned risk column: straightforward, low, moderate, or high
`mdm`	string	Overall MDM: highest of straightforward, low, moderate, or high at which at least 2 of 3 elements are met or exceeded
`description`	string	Published 2023 wording for that overall MDM type
`components`	array	problems, data, and risk criterion rows; met is true when that element meets or exceeds overall MDM
`citation`	object	ACEP reprint of AMA CPT 2023 Table 1
`disclaimer`	string	Not a medical device

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "data": "low",
  "description": "Low medical decision making",
  "components": [
    {
      "value": "low",
      "factor": "problems",
      "met": true
    },
    {
      "value": "low",
      "factor": "data",
      "met": true
    },
    {
      "value": "low",
      "factor": "risk",
      "met": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "American Medical Association; American College of Emergency Physicians",
    "id": "acep-2023-em-mdm",
    "source": "AMA CPT 2023 Table 1, Levels of Medical Decision Making, effective January 1, 2023. ACEP reprint.",
    "title": "CPT Evaluation and Management (E/M) Code and Guideline Changes"
  },
  "formula": "em_mdm",
  "formula_expression": "Caller-assigned number and complexity of problems addressed, amount and/or complexity of data, and risk of complications and/or morbidity of management using the printed 2023 MDM column labels straightforward, low, moderate, and high; overall MDM is the highest level at which at least 2 of 3 elements are met or exceeded (AMA CPT 2023 Table 1 as reprinted by ACEP)",
  "risk": "low",
  "mdm": "low",
  "problems": "low"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_em_mdm`	2023 emergency MDM inputs must match the printed problems, data, and risk columns. Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

ASA-PS — Return the caller-assigned ASA Physical Status class 1-6 with optional emergency suffix E and the published class definition (ASA 2014, last amended 2020).

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.