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Can I charge for a new-patient visit at a new practice if I saw the patient at my previous practice?

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Can I charge for a new-patient visit at a new practice if I saw the patient at my previous practice?

I'm leaving a large group to set up a solo practice, and many of my established patients want to continue under my care. Can I charge for new-patient visits the first time I see them at the new practice, which will have a different tax ID number?

Generally, no. It doesn't matter that the new practice has a different tax ID. Medicare defines a new patient as one that you (or any other provider in your group with the same specialty) haven't seen for three or more years. So if a patient has routinely come to you for follow-up care, it's inappropriate to consider him a new patient, regardless of where you've seen him. If unusual circumstances apply - you haven't seen the patient for more than two years, say, and you don't have access to his medical records - you may be able to make a case for coding his first visit to your new practice as a new-patient encounter. But be prepared to defend that decision if an insurer audits your practice.

Send your practice management questions to: PMQA Editor, Medical Economics, 24950 Country Club Blvd., Suite 200, North Olmsted, OH 44070-5351, or send an e-mail to memoney@advanstar.com (please include your regular postal address).

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health