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E/M Patient CriteriaAka: E/M New Patient, E/M Established Patient

Patient Type: New
1. Description: New to group specialty within 3 years
  1. No physician from same specialty in the same group
  2. No professional services in the last 3 years
2. Related E/M Codes for outpatient services
  1. CPT 99201
  2. CPT 99202
  3. CPT 99203
  4. CPT 99204
  5. CPT 99205
Patient Type: Established
1. Description: Care from group specialty within 3 years
  1. Physician from same specialty in the same group
  2. Professional services in the last 3 years
  3. Includes call coverage
2. Related E/M Codes for outpatient services
  1. CPT 99211
  2. CPT 99212
  3. CPT 99213
  4. CPT 99214
  5. CPT 99215
Patient Type: Not Applicable
1. Description: New and established patients charged same
  1. E/M Emergency Services
  2. E/M Consultation Services

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.