New Patient Office Visit (level 5)

This is the highest new patient office visit level: a first appointment for a problem serious or unstable enough that the decisions carry real risk. It usually means extensive data reviewed, an urgent plan made, and sometimes a decision about hospital care taken in the room. It is billed far less often than the levels below it.

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What it is

At the top of the new patient scale the question is no longer what is wrong but how quickly something has to be done about it. This level describes a first visit of high decision-making complexity: a severe illness, an unstable condition, or a treatment whose risks are substantial enough that choosing it is itself the difficult part. The clinician is typically working through a large amount of outside material — previous imaging, biopsy reports, hospital discharge summaries — and reaching a plan the same day. It is the level where the alternative of admitting the patient rather than sending them home is genuinely on the table.

Why it is done

For a first consultation about a newly diagnosed serious illness, where treatment options have to be laid out and chosen between
For a chronic condition that has become unstable and cannot wait for a routine appointment
Where the plan involves treatment with substantial risks, or stopping one for the same reason
Where the clinician has to decide whether the patient can safely be managed as an outpatient at all

What to expect

Expect a long appointment and a lot of information at once. Someone else along to listen helps, as does writing down what is decided. Much of the clinician's work on this visit happens outside the room — before it, reading what other doctors have sent, and afterwards, writing the plan and contacting the people who need to act on it. If the conclusion is that you need to be in hospital, that decision may be made and arranged during the same appointment.

Questions worth asking

If this visit ended with a same-day hospital admission or observation stay, is the office visit still billed separately from the hospital charges?
Was a prolonged-service charge added for time spent beyond the visit itself, and does my plan cover that?
If the level was set by total time rather than complexity, can the itemized statement show the time recorded?
Were scans or slides from another facility formally re-read here? A second reading of outside imaging or pathology is billed on its own.

What New Patient Office Visit (level 5) costs by state

New Patient Office Visit (level 5) cost in Texas — 87 hospitals, median $367.50
New Patient Office Visit (level 5) cost in Florida — 73 hospitals, median $964.30
New Patient Office Visit (level 5) cost in Illinois — 47 hospitals, median $427.20
New Patient Office Visit (level 5) cost in California — 40 hospitals, median $207.34
New Patient Office Visit (level 5) cost in Tennessee — 33 hospitals, median $110.40
New Patient Office Visit (level 5) cost in Ohio — 31 hospitals, median $152.75
New Patient Office Visit (level 5) cost in Wisconsin — 30 hospitals, median $347.82
New Patient Office Visit (level 5) cost in Iowa — 28 hospitals, median $367.20
New Patient Office Visit (level 5) cost in Pennsylvania — 27 hospitals, median $516.00
New Patient Office Visit (level 5) cost in Washington — 24 hospitals, median $271.96
New Patient Office Visit (level 5) cost in Georgia — 23 hospitals, median $287.72
New Patient Office Visit (level 5) cost in New Jersey — 22 hospitals, median $168.11
New Patient Office Visit (level 5) cost in New York — 22 hospitals, median $584.79
New Patient Office Visit (level 5) cost in Virginia — 20 hospitals, median $363.30
New Patient Office Visit (level 5) cost in Arizona — 19 hospitals, median $2,573.88
New Patient Office Visit (level 5) cost in Indiana — 19 hospitals, median $663.60
New Patient Office Visit (level 5) cost in Michigan — 19 hospitals, median $221.37
New Patient Office Visit (level 5) cost in Missouri — 19 hospitals, median $322.85
New Patient Office Visit (level 5) cost in Oklahoma — 17 hospitals, median $349.70
New Patient Office Visit (level 5) cost in Kentucky — 14 hospitals, median $336.88
New Patient Office Visit (level 5) cost in North Carolina — 14 hospitals, median $379.00
New Patient Office Visit (level 5) cost in Nebraska — 13 hospitals, median $388.50
New Patient Office Visit (level 5) cost in West Virginia — 13 hospitals, median $198.00
New Patient Office Visit (level 5) cost in Arkansas — 10 hospitals, median $291.85
New Patient Office Visit (level 5) cost in Colorado — 10 hospitals, median $588.82
New Patient Office Visit (level 5) cost in Mississippi — 10 hospitals, median $182.62
New Patient Office Visit (level 5) cost in South Carolina — 10 hospitals, median $264.00
New Patient Office Visit (level 5) cost in Kansas — 9 hospitals, median $1,020.46
New Patient Office Visit (level 5) cost in Oregon — 9 hospitals, median $521.25
New Patient Office Visit (level 5) cost in Maine — 7 hospitals, median $655.15
New Patient Office Visit (level 5) cost in Minnesota — 4 hospitals, median $328.00
New Patient Office Visit (level 5) cost in Wyoming — 4 hospitals, median $1,427.33
New Patient Office Visit (level 5) cost in Alaska — 3 hospitals, median $489.84
New Patient Office Visit (level 5) cost in Nevada — 3 hospitals, median $200.67
New Patient Office Visit (level 5) cost in South Dakota — 3 hospitals, median $390.40
New Patient Office Visit (level 5) cost in Louisiana — 2 hospitals, median $264.94
New Patient Office Visit (level 5) cost in Montana — 2 hospitals, median $305.60
New Patient Office Visit (level 5) cost in North Dakota — 2 hospitals, median $329.60
New Patient Office Visit (level 5) cost in Hawaii — 1 hospitals, median $114.88
New Patient Office Visit (level 5) cost in Maryland — 1 hospitals, median $175.80
New Patient Office Visit (level 5) cost in New Hampshire — 1 hospitals, median $556.00

New Patient Office Visit (level 5) prices at hospitals

See every published price for New Patient Office Visit (level 5): the full national range, the state and hospital breakdowns, and which hospitals charge the least.

New Patient Office Visit (level 5) 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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