A VISIT shall include: Outpatient primary care services, including clinical space, services of health care providers, emergency short-term pharmaceutical prescriptions. Counseling and/or coordination of care with other providers or agencies consistent with the nature of the problem(s) and the client ’s and/or family’s needs, chemical dependence and mental health. The following CPT visit categories shall be used in the identification of visits, scheduling and providing care for clients.
New Patient – Focused Visit
¨ A problem focused history
¨ A problem focused examination; and
¨ Straightforward medical decision making
¨ Provider typically spends 30-45 minutes face-to-face with patient and/or family
New Patient – Expanded Focus Visit
¨ An expanded problem focused history
¨ An expanded problem focused; and
¨ Straightforward medical decision making
¨ Provider typically spends 1.15 minutes face-to-face with patient and/or family
New Patient – Intermediate Visit
¨ A detailed history
¨ A detailed examination; and
¨ Medical decision making of low complexity
¨ Provider typically spends 30 minutes face-to-face with patient and/or family
New Patient – Extended Visit
¨ A comprehensive history
¨ A comprehensive examination; and
¨ Medical decision making of moderate complexity
¨ Provider typically spends 45 – 55 minutes face-to-face with patient and/or family
Established Patient – Intermediate Visit
¨ An expanded problem focused history
¨ An expanded problem focused examination
¨ Medical decision making of low complexity
¨ Provider typically spends 15 minutes face-to-face with patient and/or family
Established Patient – Extended Visit
¨ A detailed history
¨ A detailed examination
¨ Medical decision making of moderate complexity
¨ Provider typically spends 20 minutes face-to-face with patient and/or family
Established Patient- Comprehensive Visit
¨ A comprehensive history
¨ A comprehensive examination
¨ Medical decision making of high complexity
¨ Provider typically spends 40 minutes face-to-face with patient and/or family
