Medicare_Claims_Processing_Manual / Chapter_12 / 30.6.7(A)

Why This Topic Matters

Accurate understanding of Medicare’s new-patient definition affects whether an office or outpatient E/M visit is reported in the new- or established-patient category. The article helps readers identify the policy’s subject matter and the service types that are part of the manual discussion.

Article Sections

1. Payment for Office or Other Outpatient Evaluation and Management (E/M) Visits

   Introduces Medicare payment guidance for office and other outpatient E/M visits and identifies the code family covered by the section. It also notes the revision and effective-date information tied to the manual update.

2. Definition of New Patient for Selection of E/M Visit Code

   Explains the policy framework used to determine whether a patient is considered new under Medicare guidance. The section discusses the types of prior services and provider relationships addressed by the manual.