Provider Connection
Does a New Injury Translate to New Patient?
A new injury does not necessarily mean a new patient visit. The same rules apply under the CPT guidelines for a New or Established patient regardless of whether or not a patient has had a new injury. Use the CPT guidelines when determining “new” or “established” when billing for professional services.
From CPT Guidelines:
New Patient – A new patient is one who has not received any professional services from the physician/qualified health care professional or another physician/qualified care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past 3 years.
Established Patient – An established patient is one who has received professional services from the physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the last three years.
