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  • Internal Subspecialty Referrals, New or Established

    When the cataract specialist in our group practice refers a new patient to me, a retina specialist, can I bill the office visit as a new patient? Each physician in our practice utilizes primary ophthalmology and subspecialty taxonomies.

    Different specialties and subspecialties are generally defined by each payer. The physician’s specialty is designated during credentialing.

    Medicare identifies one specialty code for ophthalmology (18). It includes all ophthalmic subspecialty taxonomies. Any internal referral would be an established patient.

    See additional details in our article on New vs. Established: Nuances for Ophthalmology Subspecialties and Subspecialty Taxonomy Codes.