Wiki new/established

[ahaderly]

hi - we are a department of a hospital - radiation therapy - please define new patient vs established. does it matter if that patient has been seen by another provider in one of our provider-based clinics?

thanks - Anita

 

[jkyles]

Hello,

If the new/established patient rule applies to the service you're reporting then the rule would apply:
If the

clinician or a clinician of the same specialty (and sub-specialty for some private payers)​

provided a professional service to the patient within the past three years then the patient is established.