FQHC Medicare New vs Established Patient Billing
The AMA (CPT) and CMS (Medicare) have different definitions for a New Patient:
AMA- “A new patient is one who has not received any 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 3 years.”
CMS- “A new patient is one who has not received any professional medical or mental health services from any sites within the FQHC organization within the past three years.”
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