AMA CPT® Assistant - 2006 Issue 2 (February)
Evaluation and Management (February 2006)
February 2006 page 14 Evaluation and Management, 99201, 99211 (Q&A) Question Recently, a new physician of a different specialty joined our practice. Several of her previous patients are now coming to this office, and we are wondering whether these patients will be considered new or established when she sees them for the first time in this practice. Can you please clarify? AMA Comment A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past 3 years. Consider...
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Article Overview
This February 2006 CPT Assistant Q&A addresses a common evaluation and management question about whether patients seen by a physician in a new practice setting should be treated as new or established. It is aimed at coders, billers, compliance staff, and medical office personnel who work with office visit classification and physician grouping concepts. The article discusses general guidance tied to specialty, group practice, and prior professional services, with a short illustrative scenario.
Why This Topic Matters
Correct patient classification affects evaluation and management reporting and helps practices apply CPT guidance consistently when physicians move between groups or specialties.
What You Will Learn
- How CPT Assistant addresses patient status questions in a practice transition scenario.
- What general factors are considered when determining whether a patient is new in a group practice setting.
- How specialty and group practice context can affect evaluation and management classification.
- What example scenario is used to illustrate the guidance.
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Physician office staff
Codes Discussed
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