New Patient Visit – Your First Time Guide

Are you searching for a new doctor, or changing practices? Maybe you’ve recently moved or changed insurance, and you need to find a new provider. No matter the reason, being a new patient can be overwhelming. You want to find a provider that you trust with your healthcare and one that you can afford. Are you confused about why there are such varying costs for new patients versus existing patients?

The process can feel complicated, as well as expensive, but you’ve come to the right place. We will break down all you need to know about your new patient visit. 

What is a new patient visit? 

Most practices or clinics require patients to have an “initial” visit, also known as a “new patient visit”. This is the time when you will typically meet the provider, fill out a health history, and have baseline vital signs done, such as blood pressure and heart rate. This is also the time when you will give your insurance information (if you have insurance), and often receive paperwork about what services are offered at the office or clinic. Physicians will bill for your first-time visit using the CPT code 

This visit is important because if you need a referral or a procedure is done in the future, many will require you to have a “primary care doctor” or office. Your new patient will usually establish you as a patient at the practice or clinic and will allow you to have test results sent to them, schedule follow-up visits if you had surgery or a test done, and need someone to read the results. It’s important for you to have a primary care doctor or provider so that you will have a place to do your annual checkups, physicals, and screenings. 

Why are new patients charged more?

Across the country, it has been found that new patient visits are more expensive than visits for patients who have already been “established” (patients who are already part of the practice or clinic, and who have already seen the doctor). The reason for this is that a doctor needs to fully examine a new patient, have a full health history done, and may need new scans or blood tests to get a picture of their health. If a patient brings their former tests with them, the provider may still order new ones according to their diagnosis or concerns. 

Secondly, a new patient office visit would be more expensive because the doctor or provider will need to spend more time with the patient than a patient who they already know. On average, a new patient visit is approximately 30 minutes, which can be much longer than a follow-up visit or health screening. 

What a New Patient Visit Costs?

The American Medical Association has published a list of codes known as the CPT codes. These are the different charges a physician may list when they see a patient and submit for billing. From several surveys, the AMA concluded that the cost for an office visit for an established patient who spends about fifteen minutes with a doctor, it costs about $69-104. But for a new patient, a visit with a full examination will be closer to $234.

The estimated national average for a new-patient office visit is $357. If you have insurance, your co-pay may be $0-$25. Some insurance policies cover a new patient visit completely. If you are cash pay, your rate could be closer to $105. 

New patients are charged more because of the time and expertise of the physician, so be prepared for pay a larger sum at your first visit, and then see your fees gradually reduce as you become an established patient. You may see higher fees for more than your first visit, but that depends on the practice and the way they handle billing. It is best to ask them right away: 

  • How much your initial visit will cost
  • How much the visits after that will cost
  • When you will be considered an established patient

Knowing this information ahead of time will help you choose a doctor you can trust, without surprise costs after your first visit. That’s what makes ZeaMed so important: it helps you find trusted providers that are compassionate and professional, and you can shop around for the best rates. On ZeaMed, you can find discounts and even search by location, so you’ll only find the providers near you! Visit ZeaMed.com today to get started, and find the right doctor for you. 

References:
https://www.mdsave.com/procedures/new-patient-office-visit/d487fe
https://consumerist.com/2012/10/23/if-you-havent-seen-your-doctor-in-a-few-years-expect-to-pay-new-patient-fee/
https://www.beaumont.org/health-wellness/blogs/tips-for-a-productive-first-appointment-with-a-new-physician

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