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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