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E/M Codes for Group Practices

  1. Question E/M Codes for Group Practices
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    Do I understand correctly that NEW PATIENT E/M services can be billed when an individual in the same group, but a different specialty sees the patient for the first time? More specifically, when a patient has been seen by a physical therapist, can a chiropractor or acupuncturist bill using new patient E/M codes for the professional's first visit with the patient? I understand the requirements and acceptable frequency of billing E/M codes and use of modifier 25.

    Thanks in advance for your help.

  2. #2
    Salt Lake North
    Default This will depend on credentialing
    If a patient is seen by a provider of a different specialty, it is possible to bill for a new patient visit, however you cant do that unless the providers are credentialed differently.

    I have two hand specialists. One I can bill a "new patient" visit because he was credentialed as a hand specialist. The second one was just credentialed as an ortho surgeon like everyone else. So with him I cannot bill a new patient office visit due to that.

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