New Patient Office Visit (level 4)

This is a longer first appointment for someone arriving with several things going on at once, or with one condition serious enough to need careful weighing. The decision-making is of moderate complexity — outside records reviewed, prescriptions started or changed, a real plan made. It is the level most specialists bill for a first consultation.

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What it is

Some first visits are a single question; this is the one where the clinician has to assemble a whole picture before answering anything. Several long-term conditions interacting, or one that has got worse, or a new problem with enough at stake that the options have to be weighed properly. The work includes reading notes, results and imaging that came from other clinicians — often the largest part of it, and done before you are in the room. Coded by complexity this is the moderate level; coded by time it is the visit that consumes a substantial share of a clinician's morning once the preparation and the documentation are counted.

Why it is done

To take over the care of someone with multiple chronic conditions at a new practice
For a first specialist consultation where the relevant history spans years and several other doctors
For a condition that has deteriorated and now needs the treatment rethought
Where the plan involves starting or changing prescription medication with meaningful risks to balance

What to expect

These appointments are scheduled with more time. Patients commonly bring a list of medications with doses, the names of the other clinicians involved, and any results they hold. Expect the discussion to range across everything, not just the loudest complaint, and expect to leave with several things arranged at once — tests, a medication change, referrals, a follow-up. The clinician's note has to show the problems addressed and the reasoning behind the plan for this level to hold up if the claim is reviewed.

Questions worth asking

Has the practice confirmed prior authorization or a referral with my plan before this appointment? First specialist visits are a common place for that to be missed.
Can the office tell me which visit level they expect to bill, so a price estimate is based on the right code?
Were records obtained from other providers for this visit, and does anyone charge for retrieving or reviewing them?
If this appointment covers several conditions that would otherwise be separate visits, does my plan pay for it as one encounter?

What New Patient Office Visit (level 4) costs by state

New Patient Office Visit (level 4) cost in Texas — 85 hospitals, median $321.00
New Patient Office Visit (level 4) cost in Florida — 75 hospitals, median $746.85
New Patient Office Visit (level 4) cost in Illinois — 47 hospitals, median $326.40
New Patient Office Visit (level 4) cost in California — 45 hospitals, median $178.08
New Patient Office Visit (level 4) cost in Tennessee — 34 hospitals, median $84.60
New Patient Office Visit (level 4) cost in Ohio — 31 hospitals, median $121.20
New Patient Office Visit (level 4) cost in Wisconsin — 30 hospitals, median $287.10
New Patient Office Visit (level 4) cost in Iowa — 29 hospitals, median $289.60
New Patient Office Visit (level 4) cost in Pennsylvania — 28 hospitals, median $388.80
New Patient Office Visit (level 4) cost in Washington — 24 hospitals, median $217.32
New Patient Office Visit (level 4) cost in Georgia — 23 hospitals, median $226.44
New Patient Office Visit (level 4) cost in New Jersey — 22 hospitals, median $144.83
New Patient Office Visit (level 4) cost in New York — 22 hospitals, median $443.20
New Patient Office Visit (level 4) cost in Virginia — 22 hospitals, median $267.00
New Patient Office Visit (level 4) cost in Arizona — 19 hospitals, median $1,923.18
New Patient Office Visit (level 4) cost in Indiana — 19 hospitals, median $485.40
New Patient Office Visit (level 4) cost in Michigan — 19 hospitals, median $167.85
New Patient Office Visit (level 4) cost in Missouri — 19 hospitals, median $286.00
New Patient Office Visit (level 4) cost in Oklahoma — 18 hospitals, median $254.10
New Patient Office Visit (level 4) cost in Kentucky — 15 hospitals, median $296.40
New Patient Office Visit (level 4) cost in West Virginia — 15 hospitals, median $146.00
New Patient Office Visit (level 4) cost in North Carolina — 14 hospitals, median $361.00
New Patient Office Visit (level 4) cost in Nebraska — 13 hospitals, median $308.00
New Patient Office Visit (level 4) cost in Arkansas — 10 hospitals, median $237.25
New Patient Office Visit (level 4) cost in Colorado — 10 hospitals, median $529.82
New Patient Office Visit (level 4) cost in Mississippi — 10 hospitals, median $116.80
New Patient Office Visit (level 4) cost in Oregon — 10 hospitals, median $383.25
New Patient Office Visit (level 4) cost in South Carolina — 10 hospitals, median $205.50
New Patient Office Visit (level 4) cost in Kansas — 9 hospitals, median $940.28
New Patient Office Visit (level 4) cost in Maine — 7 hospitals, median $502.75
New Patient Office Visit (level 4) cost in Alaska — 4 hospitals, median $468.78
New Patient Office Visit (level 4) cost in Minnesota — 4 hospitals, median $268.80
New Patient Office Visit (level 4) cost in Wyoming — 4 hospitals, median $1,065.19
New Patient Office Visit (level 4) cost in Nevada — 3 hospitals, median $948.18
New Patient Office Visit (level 4) cost in South Dakota — 3 hospitals, median $315.20
New Patient Office Visit (level 4) cost in Louisiana — 2 hospitals, median $209.56
New Patient Office Visit (level 4) cost in Montana — 2 hospitals, median $251.20
New Patient Office Visit (level 4) cost in North Dakota — 2 hospitals, median $264.00
New Patient Office Visit (level 4) cost in Hawaii — 1 hospitals, median $84.48
New Patient Office Visit (level 4) cost in Maryland — 1 hospitals, median $146.40
New Patient Office Visit (level 4) cost in New Hampshire — 1 hospitals, median $410.50

New Patient Office Visit (level 4) prices at hospitals

See every published price for New Patient Office Visit (level 4): the full national range, the state and hospital breakdowns, and which hospitals charge the least.

New Patient Office Visit (level 4) cost — see all prices →

Sources

CMS (Centers for Medicare & Medicaid Services): Evaluation & Management Services (opens in a new tab, leaves healthcosts.net)
Medicare.gov: Doctor & other health care provider services (opens in a new tab, leaves healthcosts.net)

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