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CMS Defines "new patient"

December 31, 2010

In MLN Matters MM4032, CMS defined the meaning of “new patient.” “New patient” is interpreted to mean “a patient who has not received any professional services, i.e., evaluation and management (E/M) service or other face-to-face service (e.g., surgical procedure) from the physician or physician group practice (same physician specialty) within the previous three years.” The article states “An interpretation of a diagnostic test, reading an x-ray or EKG etc., in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient.”

Submitted by YSM Web Group on July 19, 2012