General Question for the Week of June 12, 2017

General Compliance Question of the Week

Question:

What is Medicare’s definition of “new patient” for billing evaluation and management (E&M) services?

Answer:

According to the Centers for Medicare & Medicaid Services (CMS), a new patient is someone who has not received any professional services (i.e., E&M service or other face-to-face service, such as a surgical service) 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.