The established patient status is determined by whether the patient has had professional services within what time frame?

• A. Past three years
• B. Past six months
• C. Past one year
• D. Past five years

Answer: (A)

The look-back period used to determine established status is whether the patient has had a professional service with the same provider within the past three years. This three-year window reflects an ongoing patient–provider relationship and sets apart established patients from new ones for billing and documentation purposes. For example, if the patient was seen by the same clinician 2 years ago, they’re established; if their last visit was more than 3 years ago, they’re considered new. Shorter (six months or one year) or longer (five years) windows don’t align with standard practice guidelines for defining established status.