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2009 New/Established Patient
January 2009
According to the 2009 Final OPPS Rule, the meanings of "new" and "established"
pertain to whether or not the patient has been registered as an inpatient or
outpatient of the hospital within the past 3 years.
A patient who has been registered as an inpatient or outpatient of the hospital
within the 3 years prior to the visit would be considered to be an established
patient for that visit, while a patient who has not been registered as an
inpatient or outpatient of the hospital within the 3 years prior to the visit
would be a new patient for that visit.
For example, if a patient was seen in the hospital's clinic or emergency
department (either onsite or provider-based) within the past 3 years, that
patient would be established on a future visit. However, if the off-site clinic
was not provider-based, the patient's encounter would never attribute to the
patient's future status.
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