General Question for the Week of December 28, 2015

General Compliance Question of the Week


What is the definition of “new patient” for billing evaluation and management (E/M) services?


According to the Centers for Medicare & Medicaid Services (CMS), the phrase “new patient” is one who has not received any professional services (i.e., E&M service or other face-to-face service, such as a surgical procedure) from the physician or physician group practice (same physician specialty) within the previous three years. 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.