Question

an established patient is defined as one who has seen the provider within the last

multiple choice

three years.
two years.
one year.
four years.

Explanation:

Define established patient criteria

Using the New vs Established Patient knowledge point

According to the American Medical Association (AMA) CPT guidelines, an established patient is one who has received professional services from the physician, or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.

Evaluate the given options

Using the New vs Established Patient knowledge point

• three years: This matches the standard CPT definition of 36 months (3 years).
• two years: Incorrect, as the threshold is longer.
• one year: Incorrect, as a patient remains "established" beyond 12 months.
• four years: Incorrect, as a gap of more than 3 years reclassifies the patient as a new patient.

Answer:

• three years. (Correct answer)
• two years.
• one year.
• four years.