NEW versus ESTABLISHED for HOSPITAL BASED CLINICS

I'm looking for the specific guidelines, per CMS, regarding patients who are seen at the hospital and are then asked to follow up with a primary care physician. The primary care physician they elect to see is one employed at one of the outpatient clinics owned and operated by the hospital. This patient has never been to any of our outpatient clinics (only the hospital), can we bill this as a "new" patient visit? We do have some outpatient clinics which are "specialty" offices (i.e. ENT, Oncology, Endocrinology, etc.) and I would have no problem billing these follow-up to ER/hospital services as a "new" patient. The confusion, for me, lies in the providers credentials (FP, IM, etc.) which may be the same as the ER physician who is providing care to them in the ECC.

new versus established

What physician at the hospital saw the patient? What was the specialty of that physician?

The fact that the patient was an inpatient or outpatient at the hospital doesn't have an effect on the new/established patient decision.

But, if a physician employed by the hospital saw the patient, and the physician who sees the patient in the office is also employed by the hospital, then that matters. Then, look at the specialty of the physicians.

Let's say the patient was admitted to Orthopedics, and then saw an FP in the office. Both are hospital employees. The patient is new to the FP in the office.

But, if the patient was admitted by an IM doctor, working as a hospitalist, and was then seen by an IM doctor as an outpatient (both MD's employed by hospital, same tax ID) then the patient is established in the office.

It's the part B charge that matters.