Early Adoption of the CMS Rule Change for Medical Student Documentation

Clinical documentation is a critical skill for medical students to learn and is one of the Association of American Medical Colleges (AAMC) 13 core entrustable professional activities for entering residents (CEPAERs).1 Documentation skills are also tested on the Step 2 United States Medical Licensing Clinical Skills Exam (Step 2 CS).2 However, until recently, billing related to clinical documentation by a student had been limited to non-essential elements due to the Centers for Medicare and Medicaid (CMS) rules.