new pt vs est pt

[brocal1979]

We have a brand new PCP joining our practice. We are a Pain Management office. My question is, can the PCP bill an established patient in the office as a new patient even though they have seen a pain management doctor in the office?

 

[Pam Warren]

No, once they've joined the practice and see an already established patient, they are established to a new provider. There is nice decision tree on page 6 of the AMA CPT for 2026. It's very helpful.