Billing and Coding for Nurse Practitioners: Office E/M Coding Guide
Billing and coding can be one of the MOST confusing parts of starting practice as a new nurse practitioner. What’s the difference between a 99213 and 99214? How do you figure out the right E/M code for an office visit? And how do you make sure your documentation supports the work you’re doing?
I created this episode in 2020 to make office visit E/M coding easier to understand, and it has since become one of the most-watched Real World NP videos. It’s also used by many NP programs across the country to help teach students the foundations of billing and coding.
In the episode, I break down the basic concepts behind office visit E/M coding and walk through primary care patient examples so you can start to see how the pieces fit together.
2026 Update: The foundational concepts in this classic Real World NP episode are still helpful for understanding office visit E/M coding, but the guidelines for selecting and documenting office/outpatient E/M services have changed since it was recorded.
I published a follow-up in 2021 when major E/M changes took effect, and I’m currently working on a new episode that brings everything together with current guidance. You can still watch the original episode below to learn the foundational concepts and see the patient examples, followed by the 2021 update.
For current guidance you can use in practice, download the updated Office Visit E/M Coding Cheat Sheet here.It’s also included in the Digital NP Binder.
Listen - Original Episode + 2021 Update | Listen 0:00–7:45 only → Then listen to the 2021 update
Watch - Original Episode + 2021 Update | Watch 0:00–7:45 only → Then watch the 2021 update
What I Cover in These Episodes:
In the original episode (watch/listen through 7:45):
The basics of office visit E/M coding in primary care
The difference between new and established patient visits
How the common office visit E/M codes are organized
The concept of medical decision making (MDM) and how patient complexity relates to coding
Why practicing with real patient examples can make billing and coding easier to understand
Then, in the 2021 update:
The major changes to office/outpatient E/M coding that took effect in 2021
Choosing an E/M level based on medical decision-making or total time
What work can count toward total time on the date of the encounter
The change to history and physical exam requirements—they should be medically appropriate rather than used to determine the E/M level
Additional changes, including the removal of 99201 and a brief introduction to prolonged services and the primary care add-on code that was new at the time
Key Takeaways
Office Visit E/M Codes Can Be Selected by MDM or Time
For most office/outpatient E/M visits, you can select the level based on either medical decision making (MDM) or total time on the date of the encounter. You don’t have to meet both.
MDM Is Based on 3 Elements
When coding based on medical decision making, look at:
Problems addressed
Amount and/or complexity of data reviewed and analyzed
Risk of patient management
You need to meet the requirements for 2 out of these 3 elements to support a particular level of MDM.
History and Physical Exam Don't Determine the E/M Level
You no longer need a certain number of HPI elements, ROS systems, or physical exam elements to qualify for a 99213 or 99214. Perform and document a medically appropriate history and/or exam based on the patient's care.
Time Includes More Than Face-to-Face Time
When coding based on time, qualifying work you personally perform on the date of the encounter can count—not just the minutes you spend in the exam room. This can include reviewing records, documenting, ordering tests or medications, counseling, and care coordination related to the encounter.
Don't Automatically Downcode Your Visits
A common mistake is assuming a routine primary care follow-up must be a 99213. Look at the actual problems you addressed, data you reviewed/analyzed, and management risk before choosing the code. A visit may meet moderate MDM even when it doesn't feel particularly complicated.
Want to keep the current coding criteria handy?
Download the free Billing & Coding Cheat Sheet to quickly work through office visit E/M coding in practice.
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Liz Rohr:
Oh man. Another highly requested topic today is about billing and coding. This can be super confusing. Especially as a brand new nurse practitioner, we don't really talk about it that much in school and you have to learn it on the job. So, in this video, I'm going to be breaking it down, talking specifically zeroing in on office visits and primary care. If you're new here, I'm Liz Rohr from Real World NP and you're watching NP Practice Made Simple, the weekly videos to help save you time, frustration and help you learn faster so you can take the best care of your patients. So, a couple of disclaimers before I start. Number one, I'm talking about primary care only. I am not savvy enough to talk about skilled nursing facility, long-term acute care or hospital-based medicine because that's just not my expertise.
So, if that's you, you may want to skip this one. Disclaimer number two is I am not a billing and coding expert. I'm a self-taught nurse practitioner who has also gotten guidance from billing and coding. I'm using the CMS evaluation and management guidelines, which I'm going to be linking down below but that's based on that's what everybody uses to justify their billing codes. The third thing is that there are many different types of visits you can build for in primary care. So, number one, what I'm going to be covering today because it replies to the vast majority of visits you're going to see in primary care office visit. And you might say they're all office visits, however, there's different billing for preventative health care, meaning a physical, a well-child check.
There's definitely a different one for a Medicare physical and the procedures are a little bit different as well. So, because the vast majority is office visits, I'm going to be focusing just on that today. However, I'm also planning on doing a preventative video if that is of interest to you and how to maximally accurately code your billing. I'm not talking about manipulating or gaming the system to get the most of your money, I'm really talking about accuracy because people tend to want to under bill or over bill. And really it's just important to get the facts and document and bill appropriately. So, I'm going to share my screen with you to make this really easy. But a couple of notes first.
Number one, there's a cheat sheet down below this video with a couple of tables, examples and references and really the absolute easiest way absolutely go through and watch and listen to this. However, the easiest way to get a handle on this yourself is to practice. And it doesn't take that much time. It takes a little bit of time and it doesn't take that much time of going through some examples, figuring out what the billing code would be based on that. And then once you have that muscle memory of having done that a couple of times, it'll be way easy. Three things. Number one, when it comes to billing with at the end of your visit and you've got your note done, you're going to think about the charge.
The first thing you're going to think about is your level of medical decision-making. And basically what that means is how much of your brain are you using? So, is this a very simple allergic rhinitis that you can treat with over the counter medication versus is this an acutely decompensating person with CHF in the clinic that you're thinking about sending to the ER? Those are very different levels. Just stick with me, I'm going to break this down. You stratify it based on that medical decision-making is what it's referred to as. And it's a level one to five. So, level one is the least acuity. So, somebody, for example, who has allergic rhinitis and you treat prescribe them Flonase, which is available over the counter versus a level four or five with those more complex patients.
So, a medical decision making is your very first thing. Number two, what you want to think about is how do you support it with your documentation. Start with the medical decision-making and then just make sure that your number that you're submitting, that you've chosen for your medical decision-making is backed up with the appropriate amount of documentation, which you'll see in just a second, stick with me. And number three, when it comes to office visits, there's two other branch points is one, is this is are they new or are they an established patient in your practice? So, if they've never been seen there before, they're a new patient or if it's been greater than three years versus if they've been seen them in the last less than three years, then they're typically an established patient.
And the reason that's important is because new patients typically reimburse more money because there's typically more work involved. But that also means that you have to document more to support your case of why you get to charge for that higher amount of money. So, let me jump in and I'll share my screen with you. Okay. So, just a quick recap. So, number one, you're going to start with your medical decision-making when it comes to billing your ENM codes, which is, again, those level one to five. You're going to think about if they're new or if they're established and then you're going to just make sure that all of your documentation is there to support it. And it actually you're going to find that it's a lot less than what you think it is.
So, I'm just going to go over starting with established because those are the most common codes you're going to see. And so, level one is typically a nursing visit. The prefix is always 992 and then the last two numbers are the things that are different. So, 11 is a nursing visit. 99212 is a minor problem. For example, allergic rhinitis, things like that. And I actually have a whole table. If you haven't downloaded the cheat sheet already, it has the table of risk that is in the CMS guidelines. It talks about all the different examples, not all of them but it's not comprehensive but you can extrapolate based on what the examples that they gave you are. And then also the different tables that I have put together based on the guidelines and then the data that's been published after, which I'll show you in a second on this presentation.
But definitely download that if you haven't already. So, 99213, the level three is for an example is an acute illness like a cystisis or one stable chronic illness. And then level, 99214 is two or more chronic illnesses or if a chronic illness is worsening or for example, if you have an undiagnosed new problem with an uncertain prognosis like abdominal pain... And then, I'm sorry, that should say 99215. That's a severe exacerbation. And I've actually never coded for a level five in primary care. And you'll see when you look at the table of risk, assessing the different options, the different examples of it that are there, typically those patients need to be cared for in the ER or the hospital setting.
And I felt conflicted over the years about do you code for that at level five because you're sending them out or do you code them only on level four because you're not doing that level five intervention because you're sending them out for that. So, definitely get clarity in your own practice with your supervisor or a billing and coding. I've never really gotten any feedback about my incorrect level five. So, I just don't have any, I guess. So, those are the established codes. And ENM codes are basically the same for new in terms of your medical decision-making, which again, I keep talking about because that's the most important thing.
It just requires more documentation. So, it just ends in 01 instead of 11. So, 99201, 99202, 203, 204 and then 205. So, again, when you're looking at your billing codes, you're deciding which one to pick, you're going to start with your medical decision making. And I'm actually going to toggle over to the cheat sheet that I... Oops, that I made. Well, first of all, yeah. So, first of all, I'm going to talk, we'll start with the one that I made. So, at the very top, what you're going to do is, again, this is talking about medical decision-making. And this is literally when I talk about practicing, this is exactly what you can do on a sample of your own notes or somebody else's note and check off the boxes to see if they actually qualify for the billing code that they chose.
So, if somebody documented a four, you can go through and literally check the boxes off of this whole cheat sheet for each note that we're talking about or that you're looking at and you can see, did they meet the criteria, right? Just for fun. Again, it takes a little bit of time but even if you just did three notes, you would feel I think a lot better about it. So, anyway. So, again, step one is looking at your level of risk. And so, this table here is not part of the guidelines but it was made after to help guide clinicians. And I saw it cited from a variety of sources in different ways. And I put it together in this way that was helpful. I had a resource in the past that had this already made out and I can't seem to find it. But this is based on putting all the data together into this table.
So, anyway, this is the guidance that has developed after the guidelines came out. So, what you're looking at and actually going back to the presentation, the three things here are risk, problem points and then data points. I'm sorry. It's not letting me do that. So, what we're looking at here is your risk. If the level of risk of the problem, the data points involved and then the problem points. And so, underneath here are the problem points and then data reviewed points. So, let's just start with the table of risks. So, this is literally out of the guidelines. This is the table of risk from CMS guidelines. And it typically matches up this way. It's not written on here but you could print this out. And then I have this printed out at my desk but you could print it out and write next to it.
Typically level of risk minimal is a level two, low risk is a level three, moderate is a level four and then high risk is a level five. And what's on this table is you're looking at the different problem examples. The middle column is diagnostic procedures ordered and then management options selected. And you don't necessarily have to have one, two and three for them to qualify for minimal. But if it's helping inform you make your decision. So, what testing are you doing for this problem? What interventions are you doing for this problem? So, if your intervention for your problem is gargles and rest, likely it's a minimal risk problem, right? If it doesn't say it here, insect bite, tinea corporis, things like that.
So, tinea is interesting because you can prescribe for it but I believe it's because it's over the counter like clotrimazol is, the treatment, that's why it's considered like a minimal risk one. But anyway, like I said, you don't have to have all of these but you're looking at the reason to print out this table is that you can look at the examples here of the different presenting problems to help guide you in that medical decision making. So, if we toggle back here to this cheat sheet. Again, you're literally going to fill this out. So, what is your level of risk for your problem? Is it minimal, low or moderate? Again, because the high risk ones are typically you're sending them to the ear.
Because if we scroll down to the high risk ones, they're having elective major surgeries, emergency major surgeries, things like that, which you're not doing in primary care. But you can select here. So, I'm going to slow down for a second. So, again, now, level two, self-limited or minor problems like a cold upper respiratory infection, that's just supportive care, insect bite, things like that. A level three, a low risk is two or more self-limited or minor problems. So, if you had a couple of those or if you had one stable chronic illness, well controlled hypertension, not insulin-controlled diabetes, patients who have BPH or one acute illness like a cystitis or allergic rhinitis, things like that.
Actually, I thought that was under minimal but I guess that's considered a low risk one. So, you couldn't bill for three if you had allergic rhinitis. So, moderate, those are one or more chronic illnesses with a mild exacerbation. Two are more stable chronic illnesses like diabetes and hypertension, things like that or an undiagnosed new problem with an uncertain prognosis. And again, like I said, the vast majority of the time moderate is going to be a level four but it depends on this further calculation. So, let's just go back for a second. So, you're looking at the end of your note and you're looking at the billing code, you're looking at the level of risk, which you're going to look at that table of risk from the CMS guidelines.
And then you're going to scroll down to these tables and then add them up. And the important point here is that you need two out of three of these. You don't necessarily need all three of those to qualify but let's just go down. So, problem points. What are the points that are associated with that? Again, these are not in the guidelines but this is guidance that was developed after the guidelines. And so, for example, if you have somebody with a cystitis, you have an option of a self-limited or minor problem established problem, that's stable or improving, an established problem that's worsening or a new problem but you don't have any other workup planned or a new problem with additional workup planned, right?
That makes sense in terms of your clinical decision making, right? So, for an example, if you have somebody with cystitis, you have a new problem but no further workup is planned. You just did maybe do the year analysis, right? But you're not necessarily going to send out a culture because you can treat them empirically. And so, what you're going to do is go back to their table of risk. I know from looking at this a thousand times, that cystitis is qualified under the low risk level. And that's a level three. She doesn't have systemic symptoms. For example, if we're talking about a woman who comes in with this area. So, we're in a low risk and we're looking at the problem points.
So, it's a new problem with no additional workups. So, let's say level three. So, it could technically fall into a level four but the risk needs to be moderate. So, it has enough points to qualify for level three but not enough to qualify for a level four, if that makes sense. And then your data reviewed points. We actually don't need to do this for that particular example, because again, it's only two out of three. But you could look at the data reviewed points. So, did you order any lab tests? I guess if you sent your analysis would count, x-ray, EKG, did you discuss the tests with the performing physician or you were talking about a specialist, ordered some labs and then you get on the phone and talk to them or if you independently reviewed an x-ray or an EKG tracing.
If you went through old records and things like that, review information, you get like different data points involved there. And you can have multiples, right? Which will add you up to that three, if you're looking at a level four type of visit. So, again, step one, you're looking at medical decision-making, you're literally going to these points, looking at this table of risk and filling it out. And do they qualify or not? And so, let's go back to the presentation here. So, again, those three things, risk, number of problem points and then the data points and then your documentation. And I'm going to try not to bore you to death because I'm clearly I'm excited about this but you just want the nuts and bolts so you can do it right.
So, I'm going to try and be as brief as possible. But basically, these are the elements that your note needs to have. And the amount that you document is what differentiates levels two through five or one through five. But again, we're not really doing level ones. Everyone needs a chief complaint, regardless of level. Number two, everyone needs an HPI. However, the difference is how much you document. Number three, past medical history or surgical history, family history and social history has a star next to it because actually only the ones that need that are new visits are a little bit different but established visits for a four and above are the only ones that actually require that to qualify.
ROS. I have that, everybody should have that. I mean, typically if you're doing a note, you're going to include some kind of ROS, right? But technically if you have a level two problem, you actually don't need to document anything under the ROS. And then for the levels three and four, this is for established patients, you just need to document a certain amount. And it's actually less than you would expect. And then five is a physical exam. And every level of visit that you see has to have a physical exam. So, I'm just going to toggle back over to the cheat sheet because I think it's easier to look at this way first. So, on the second page is the documentation required for each level.
So, like I said, these are all of the elements. I'm not going to talk about time today because there's something I'm just going to say that for another time. But again, you start with your medical decision-making. If it's straightforward, low complexity, moderate complexity or minimal is another way to say straightforward. And these are for established visits again, 99212. And actually, I'll update that before I send it out to you. That it'll say established in new to for clarity. But basically, it's a lot less documentation than you think. So, if you have a 99212, if you have somebody with tinea corporis nothing else, all you need to do is one to three elements in the history.
You don't need an ROS. You don't have to document the surgical family, social history. And then the physical exam comes down to either body systems or elements. And I'm not going to bore you with the details but there's different guidelines from 97 and 90, 95 to 97. Actually, I didn't mention that these are all based off of recommendations from 1995 and 1997. So, if you're worried about things being up-to-date, they haven't really been updated in a very long time. But there are two options. You can either talk about elements, which is regular rate and in terms of cardiovascular exam, regular rate and rhythm, lungs clear to auscultation and the respiratory. Those are two different elements.
Those are two distinct elements versus the body system is cardiovascular, respiratory, et cetera, et cetera, if that makes sense. And so, that's a level two. A level three, one to three elements. And just hold that thought, I'm going to show you what the elements are. ROS, you really only need to do one system, which is pertinent to the problem that's in front of you or if you're talking about hypertension follow-up, you could do cardiovascular, things like that. You don't need a past surgical family history, social history. Although, most likely you're documenting this and it's typically recommended, right? You are curious about their smoking status if you're talking about hypertension, right?
But in terms of the bare minimum of what you need to have, that's what it is. And so, again, for level three, for those moderate risk ones, you can either do the elements, those bullet points within each of the body systems like throughout the body systems versus do you want to do two organ systems that are relevant, right? So, if we were talking about dysuria, you want to talk about the GU organ system. And then you probably want to talk about GI too at least, right? You want to talk about the systems that are relevant to that complaint. And then again, your medical decision-making, we've already determined that. And you just want to make sure that once you decide that medical decision-making, you can go back and make sure you have all of the things.
The takeaway here is that I'm going to toggle back and I'll show you what HPI elements are. But basically in summation, it's like your old car, right? Your onset location duration. Each of those things are one element, which is insane to me when I were learned this because you only have to say onset location duration and that's three elements and that's all you need for level three, for one acute complaint, right? And then four or more, so, onset location duration and have they taken any meds? That's four. Four or more qualifies you for basically anything else? And then the ROS for the level four, it's two to nine systems, again, cardiovascular and respiratory, right? Or depending on the problem of what it is choosing those.
And it doesn't necessarily specify that. This is the major kicker here. And this is when I talk about using examples and making sure that your documentation supports it, this is the most common thing that I see in number one, my own documentation but also looking at others, if you're doing like an audit or something, is that if you charge for a four and you have all this complex medical decision making, if you haven't documented on the family history, that's what's going to trip you up and you're not going to qualify, right? So, I think that's my takeaway. My personal hack here. And I don't know if this is correct. So, maybe check with your billing department before you do this.
But I typically chart as if every visit is a four. I mean, within reason, right? But I always document some social history that's pertinent, right? And smoking has always pertinent to whatever is going on, right? And then physical exam. I'm so sorry. I forgot. I'll update this when you have it in front of you. But it should be, say five to seven organ systems or body systems. And those are the typical ones that we're talking about, right? General, cardiovascular, respiratory GI, GU, et cetera, et cetera. So, you can either do 12 bullet points or you can do that five to seven body systems. And those are the patients that have moderate complexity.
And then just briefly and again, I'll update this before I send it out to you. This is the new patients. So, the medical decision-making, as you'll see and this doesn't correlate because this is too. So, look at this column and then look at this column. But the three and the three, sorry, I shouldn't have done it that way. But you'll see that the complexity is the same, low and low, moderate and moderate and then five is high and high. So, the medical decision making is the same. However, if you look and you look at the three, there's a lot more to document. So, basically, if you have a new visit, you just want to toggle all the way over to the highest level of documentation, to be honest. So, if you have a level three and it's a low complexity, most likely you're going to have a moderate complexity, right? Depending on where you're practicing.
But if you have somebody with uncontrolled diabetes and hypertension, that could probably qualify for a moderate. And so, you want to make sure there's at least four elements in the HPI. Again, onset location duration and things like that. ROS, you actually want to do 10 body systems. You definitely want to address the family history. And it depends. I saw conflicting resources about, do you want to address all of them? Social history, past surgical history, family history. I typically do for my new patients. So, I recommend doing that. But I think what I read was either all three of those areas need to be addressed or just one. And the physical exams has 18 elements. And again, those are bullet points.
I couldn't really find a resource that said how many body systems, probably that would qualify in five to seven body systems in terms of again, regular rate and rhythm, lungs clear to auscultation, et cetera, et cetera. Yeah. And then just basically, you're just moving at one forward. And so, you're documenting more than you need to for those new patients. So, just toggling quickly back to that presentation. So, the elements I'm going to go through this quickly and you can just look at this. Again, location is one element, quality aching is one element. And most likely if you're most clinicians are going to, especially if you're brand new, you're probably documenting in all of those things. And that makes for a great history, right?
But at the very bare minimum, you have to have at least three for most visits. And again, I already mentioned this. ROS is based on the body systems. And again, these are the ones that you're familiar with, right? So GU, GI, hematologic, musculoskeletal. Again, you just want to choose a certain number of systems depending on how high of a billing code you're choosing. And you can go refer back to that cheat sheet. And then, either again, elements or the organ systems. So, I've listed here the organ systems. And again, it's about five to seven for that four and above. And you could probably even just do up to 10 or you can choose it based on the elements of the bullet points, well developed, well nourished, once cleared oscultation, regular rate and rhythm, abdomen soft.
Those are all elements. Yeah. And then a couple of patient examples. I'll just do two here, a 33 year old female with dysuria. So, this is basically how you would use this. And again, you're just going back to the top of the office visit. You're doing medical decision-making first. So, we have a 33 year old female with dysuria who you're diagnosing with a UTI and you're prescribing some antibiotics. So, you're going to go to the table of risk first. This is the most important first step and then you're going to look again. I keep giving this example. I'm sorry I copped out and I gave somebody this example.
But somebody with an acute uncomplicated illness or injury. So, she didn't have fever, chills, she didn't have signs of pyelonephritis. Because again, that could actually bump her up into the next category whereas it systemic symptoms like IE pyelonephritis, things like that. That could bump her up to that level but she just has [inaudible 00:23:16]. So, we're going to do a low level. And so, now, you've assessed your risk. She is a a low level. So, she could qualify for a three. However, you want to make sure she at least qualifies for the data points or the problem points. So, we're going to scroll down.
She has a new problem with no further workup plan. So, she has a level three. So, she definitely meets criteria there. And we don't even have to look at the data points but we could. Did we order some blood tests? Maybe we did. I don't know. I don't think we did. We're going to leave that alone. So, that's it. So, you would definitely build for at least a level three and then the documentation you need to do. Let's scroll down onto the next one because again, first one is medical decision making and then second is to make sure you documented enough. So, for level three, low complexity, three elements, onset location duration started yesterday, I guess, location dysuria, right? Urethral burning. And is it coming and going? Is it there all the time, et cetera, et cetera.
And then one body system. You do the GU, ROS. That's all you need. You don't have to talk about the family history, social history. Again, I recommend doing this, use your clinical judgment and do the best nurse-practitioner care. However, this is why I tell some new nurse practitioners that I work with or that I've worked with in the past also that you don't have to chart as much as you're charting. However, just do your due diligence job. But yeah. So, six elements are two organ systems. So, you could do GU and GI. And those are your physical exams or whatever is pertinent, right? You won't necessarily do a GU exam on somebody who has dysuria but abdomen and cardiovascular or something, respiratory. I typically do heart and lungs for most visits.
And that's it. And those are all the things that you need to document because these are all established patients. And so, just one more example, again, I don't want to bore you to death. So, this is a 56 year old man with uncontrolled diabetes and hypertension. And so, we're going to first go over, scroll back up to the beginning of this and we're going to look at the risk. So, we're going to go over to that table of risk. And there's two problems with uncontrolled diabetes and hypertension. And so, I already know we're going into moderate, right? Because we're going to one or more chronic illnesses with a mild exacerbation because. And so, this is a moderate level four. And so, because this only says one or more chronic illnesses, I guess it says or more.
But if it was only one chronic illness, you want to look at the next category, like would this qualify for a five, one or more chronic illnesses with a severe exacerbation? So, I would not qualify mildly worsened hypertension, the diabetes as being severe. Again, you might want to get clarity from your supervisor or from billing to make sure that if your A1C is 13 and your blood sugar or high blood pressure is like 210/100, maybe that's a little bit different. You might bill for a five. I'm not sure. Definitely clarify on that. So, anyways. So, that's a moderate complexity. So, it could qualify for a four. So, let's go over to the problem points in the data reviewed.
So, problem points. So, we've got an established problem worsening. We definitely get two points there. And I think my lingering question here is that I believe this qualifies for a four because it is only giving it a two because it's an established problem but it's actually two problems that are worsened. So, I think that you could actually bump it up from there, if that makes sense. So, that could be a three. And then data reviewed, did you order any blood tests that day? Did you review their past records?
And approval here, I don't remember if I mentioned this already. It's not enough to say reviewed labs. I mean, you can either input the labs themselves or you can say things like white blood cell was high, chest x-ray was unremarkable. Those are considered acceptable. But you want to say, especially if you're getting old records, you want to talk about why and what that means and the ramifications of that, not just the physical act of, "Oh, I requested their records, which I didn't really understand at first," but that's in the guidelines themselves. So, that's pretty much it.
If you like this video, if so hit like and subscribe and share with their MP friends so together we can reach as many new nurse practitioners as possible to help make their first year as a little bit easier. And if you haven't grabbed the cheat sheet from this video down below, definitely do that. You'll also get these videos sent straight to your inbox every week with notes from me, patient stories and bonus content I really just don't share with anywhere else. Thank you so much for watching, hang in there and I'll see you soon.
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