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Billing Established Patients for new PA

  1. #1
    St. Joseph County, Indiana
    Default Billing Established Patients for new PA
    Medical Coding Books

    We have a PA that left an existing practice and is starting with our practice in the next few weeks. When his established patients are seen in our office, are they new or established?

    I assumed they would be established but are unsure.

    Also, if the physician wishes to see the new PA's patients first, THOSE PATIENTS would be considered new patients, correct?

    Brock Berta

  2. #2
    Changing Group Practices

    What about the physician who leaves one group practice and joins a different group practice elsewhere in the state? Consider Dr A who leaves his group practice in Frankfort, Illinois and joins a new group practice in Rockford, Illinois. When he provides professional services to patients in the Rockford practice, will he report these patients as new or established?

    If Dr A, or another physician of the same specialty in the Rockford practice, has not provided any professional services to that patient within the past three years, then Dr A would consider the patient a new patient. However, if Dr A, or another physician of the same specialty in the Rockford practice, has provided any professional service to that patient within the past three years, the patient would then be considered an established patient to Dr A. Remember, the definitions include professional services rendered by other physicians of the same specialty in the same group practice.

    __________________________________________________ __
    Saw the above in CPT Assistant June 1999

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