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Thread: New Pt level for OMT

  1. #1

    Default New Pt level for OMT

    AAPC: Back to School
    I have a provider who wants to charge a new patient level for patients that are seen by another practice and referred to her for OMT. They are both under the same tax id.

    Does anyone know if it is appropriate for her to charge a new patient level? I was under the impression that they could not charge a new patient level when seen under the same tax id unless they are being seen by a specialist.

    This provider sees mostly family practice patients but does OMT. Is she considered a specialist? Would this allow her to charge a new patient level?

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    What is her actual specialty? And what is the specialty of the provider(s) who are sending patients to her for OMT? If the same specialty (i.e. Family Practice), and the same group, the patients are established. If a different specialty, they can be considered new patients as long as she or someone of the same specialty in the group have not seen them in three years. Also, be sure any E/M is truly a significant, separately identifiable service from the OMT.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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