baport12
New
Whether providers within the same group, same specialty, and same subspecialty can each receive data credits towards Medical Decision Making (MDM) for reviewing the same lab data (e.g., a CBC performed on 03/14/2026) across multiple separate visits. (Please see detailed inquiry below).
We cannot find language by AMA or CMS that specifically outlines the restrictions that the same test cannot be data credit by providers in the same group.
We comprehend the concept that all three physicians are in the same group and specialty, the group is viewed as a “single physician/entity”
Same Patient -Multiple Visits within the Same Group Practice, Same Specialty, Same Subspecialty (Seen by Same Provider and Other Providers within the group on different dates of service)
Example:
Dr. A orders and review CBC on 03/14/2026, Dr. A get data credit for order.
Dr. B sees patient on 03/20/2026 reviews the same CBC dated 03/14/2026-Does Dr. B get data credit, as this lab is relevant to his treatment plan on this date of service.
Dr. A sees patient on 03/31/2026 and reviews the CBC dated 03/14/2026, as he states it is relevant to his treatment plan on this date of service.
Dr. C sees the patient on 04/15/2026 and review CBC dated 03/14/2026 and determines the CBC is relevant to his treatment plan on this date of service.
We cannot find language by AMA or CMS that specifically outlines the restrictions that the same test cannot be data credit by providers in the same group.
We comprehend the concept that all three physicians are in the same group and specialty, the group is viewed as a “single physician/entity”
Same Patient -Multiple Visits within the Same Group Practice, Same Specialty, Same Subspecialty (Seen by Same Provider and Other Providers within the group on different dates of service)
Example:
Dr. A orders and review CBC on 03/14/2026, Dr. A get data credit for order.
Dr. B sees patient on 03/20/2026 reviews the same CBC dated 03/14/2026-Does Dr. B get data credit, as this lab is relevant to his treatment plan on this date of service.
Dr. A sees patient on 03/31/2026 and reviews the CBC dated 03/14/2026, as he states it is relevant to his treatment plan on this date of service.
Dr. C sees the patient on 04/15/2026 and review CBC dated 03/14/2026 and determines the CBC is relevant to his treatment plan on this date of service.