Skip to main content

October 8, 2013 - Revised: 08.11.14

Reminder: New Patient Visits

As a result of overpayments for New Patient Evaluation & Management (E/M) services, CMS has implemented changes in the Common Working File (CWF) to prompt for validation of new patient status. This may result in overpayments being identified and requested for new patient E/M services that are determined to have been submitted as “new patient” in error.

CMS guidelines specify that “new patient” means “a patient who has not received any professional services, i.e., E/M service or other face-to-face service (e.g., surgical procedure) from the physician or physician group practice (same physician specialty) within the previous 3 years.”

For More Information:

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved