Forum - Questions & Answers
New patient vs established
Provider leaves one group and goes to another. If he takes a patient he recently saw in the old group is that patient new to the new group?
re: New patient vs established
Per CPT® guidelines, a new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice , within the past three years.
re: New patient vs established
No, Established if seen within 3 years.
re: New patient vs established
Q10. Doctor A is new to our group. If a former patient sees Doctor A under our group, is this patient new or established?
If Doctor A sees his/her former patient, the service is an established patient visit. Doctor A's NPI shows the provider has seen the patient within the previous three years.
http://www.wpsmedicare.com/j5macpartb/resources/provider_types/2009_0727_newpatientservices.shtml
CPT® does not set reimbursement rules