New Patient Visit

Policy Update #: POLNPV080124

Effective Date: August 1, 2024

Current State: New patient edit did not consider services rendered by nurse practitioners (NP) or physician assistants (PA)

Future State: The new patient policy edit will be updated, effective August 1, 2024, to include NPs and PAs to ensure appropriate reporting of new patients. A new patient is
one who has not received any professional services from the physician, or other qualified healthcare professional of the same specialty who are providers in the same group practice, within the past three years.

Applicable Plan(s): Commercial
Applicable Policy: Policy Number: 4036

Business Owner: Cost of Care

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New Patient Visit