Answer
In most instances, a new problem is one that is new to the provider and being addressed at that visit. There are two exceptions to this general rule:

  • The initial visit of an established beneficiary in a single specialty group practice setting with a new provider
  • A visit by an "on call" or covering provider. In these instances, the established problems are treated as if the beneficiary was seen by the unavailable provider.

Resources

 

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department


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