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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.
CPT® copyright 2023 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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