Under Office/Outpatient E/M Services, how many years must be considered to select either "new" or "established" patient options?

Under Office/Outpatient E/M Services, how many years must be considered to select either "new" or "established" patient options?

• A. 1 year
• B. 2 years
• C. 3 years
• D. 4 years

Answer: (C)

To determine whether a patient is classified as "new" or "established" under Office/Outpatient Evaluation and Management (E/M) Services, a timeframe of 3 years is considered. A "new" patient is one who has not received any professional services from the physician or from another physician of the same specialty in the same group practice within the last 3 years. This classification is crucial for billing and coding purposes, as the complexity and level of service provided can differ significantly between new and established patients. By focusing on this 3-year period, healthcare providers can accurately assess and document the patient's relationship with the practice when selecting the appropriate billing code.

To determine whether a patient is classified as "new" or "established" under Office/Outpatient Evaluation and Management (E/M) Services, a timeframe of 3 years is considered. A "new" patient is one who has not received any professional services from the physician or from another physician of the same specialty in the same group practice within the last 3 years. This classification is crucial for billing and coding purposes, as the complexity and level of service provided can differ significantly between new and established patients. By focusing on this 3-year period, healthcare providers can accurately assess and document the patient's relationship with the practice when selecting the appropriate billing code.