Rules For E/M Codes (New vs. Established Patients).

The American Medical Association defines a new patient as someone, “who has not received any professional services from the physician/qualified healthcare professional or another physician/qualified healthcare professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.”

But, what is a professional service? How do we determine exact same specialty and subspecialty, and same group practice? And then, of course, we need to talk about the 3-year rule.

Billing for new vs. established patient evaluation and management services can be confusing. What can be particularly baffling is the need to consider the CPT and Medicare guidelines all while knowing the caveats within each.

Watch this on-demand webinar to better understand coding distinctions and to properly determine which category to use. We'll discuss the four main components of new vs. established and how to:

• Understand Professional Service
• Distinguish Between Same Specialty/Subspecialty
• Breakdown Same Group
• Make sense of the 3 Year Rule