Wiki 2021 E/M Changes New Patients

[rthomas@impcna.com]

I know under the new guidelines if you are using Medical Decision Making to determine the level of service for an established patient that you MUST meet 2 out of 3 MDM requirements but what about New Patients? If using MDM do you have to meet 3 out of 3 or is it 2 out of 3 just like established patients? I have participated in all the webinars and virtual workshops but do not remember any mention regarding new patients.

 

[thomas7331]

As currently written under the new guidelines, MDM or time will determine the level the same way for both new and established patients. The determination of MDM will continue to require meeting 2 out of 3 of the categories for a given level from problems, data and risk, the same as it currently does (only with some new criteria in each of these categories).

There would be no 3 of 3 requirement for new patients, since that only applied to history, exam and MDM, which will no longer be the case for the office visit/outpatient E&M codes if and when these guidelines are finalized.