Optometry Coding & Billing Alert
Reader Questions:
Heed Insurer Preference on New Patients
Published on Mon May 25, 2015 
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Question: If a provider of a different specialty within the same group sees the same patient on a different day (or even the same day), can they charge a new patient visit even though the patient has been to the practice before?
Answer: Typically, yes, but it depends on the insurer’s recognition of that specialty. Some payers consider neonatal specialists the same as pediatricians from a specialty standpoint, for instance, even though Medicare gives them separate specialty designations. So if the insurer allows it, then you can absolutely bill a new patient visit in that situation.
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