The Joint Commission has revised their Medical History and Physical requirements for Office-Based Surgery and Ambulatory Health Care Accredited Organizations effective July 1, 2021. The new standards now indicate a Medical History and Physical Exam is performed as needed. The organization develops written policy on the criteria for which patients a medical H&P must be performed. This change applies to all operative and high-risk procedures, and before moderate or deep sedation and/or anesthesia is administered. The organization’s policy must be based upon standards of practice and nationally recognized guidelines and also be in compliance with state and local laws. The policy must establish the timeframe for the completion of the examination and define specific patient factors such as patient age, diagnosis, co-morbidities, anesthesia plan and number of procedures to be performed.