E/M update: Navigate new vs. established patient distinctions during COVID-19

Why This Topic Matters

Patient-status distinctions can affect whether a service is reportable under a given code and how telehealth claims are reviewed during the public health emergency. Understanding the article helps practices apply CMS guidance consistently and prepare for later audits or policy changes.

Article Sections

1. COVID-19 PHE and patient-status enforcement discretion

   Introduces the public health emergency context and CMS guidance related to established-patient language in certain virtual E/M services. It frames the temporary policy environment discussed in the article.

2. New vs. established matters for telehealth

   Explains why patient status still needs to be checked for telehealth services with separate new- and established-patient structures. It also summarizes the service categories affected during the emergency period and notes the temporary nature of the coverage changes.