Wiki New vs Established for NPP

[jadykes.cpc@gmail.com]

We have an ANP specializing in women's health joining our group who will be bringing her own patients with her to our surgical practice. I am confused as to new vs established designation for patients who have seen her in the past. I believe they will be established because she will have seen them within the last three years. Also, a surgery patient that is established with our group will be considered established for her even though she may never have seen them before. Am I wrong? Can someone give me some guidelines for this? Thank you.

 

[mcpalmeter]

New vs Established NPP

Always established to same provider if same provider has seen patient in past 3 years.


Per CPT, when APNs and PAs are working with physicians they are considered as working in the exact same specialty and exact same subspecialties as the physician. As such, a patient seen in past 3 years by a physician in the surgery group (assuming all physicians in surgery group are of the same exact specialty and subspecialty) would be considered established to the APN even though the APN had not seen the patient in the past 3 years.

Regards,

Maryann