Group visits Billing Information

Group visits Billing Information ??

Group visits were identified in the Future of Family Medicine project as one of ten features that have the potential to generate increased revenue. There are several models for group medical visits. Group visits include a group educational session plus most components of individual visits, including one-on-one medical evaluations conducted by a physician or nurse practitioner. A group visit is NOT a class or a group therapy session. Group visits can also provide an improved quality of care and a higher level of patient and physician satisfaction.

Medicare & Medicaid Guidelines

Medicare & Medicaid Services point out that a physician can provide a medically necessary face-to-face E/M visit that is observed by other patients. The physician must not allow any activities associated with the presence of the observers, or with any subsequent group counseling encounter, to impact the level of service reported for the history, exam, counseling, instruction, or medical decision making furnished during the face-to-face encounter with the patient. If your group visit includes services provided by nutritionists or behavioral health specialists, check with your payers to find out if these health professionals can bill directly. Group visits offer a cost-effective solution. In contrast to the typical 15-minute office visit, a two-hour group visit with 20 patients permits ample time for education and discussion.

The benefits are wide-ranging: reduced health care expenses improved patient and provider satisfaction. All the participants must share one common diagnosis and that group activity is not limited to the film/presentation etc. It can be a round table activity with at least 20 – 25 participants and Q&A is included in this activity.

Group visits can proceed relatively smoothly if you plan them carefully in advance. Each part of your planning process sets the stage for you to empower your patients to improve their compliance and clinical outcomes. Not all patient problems are appropriate for group visits. Physical exams, acute care needs, and topics involving sensitive personal issues should continue to be addressed on an individual basis, but many types of medical problems lend themselves to the group-visit format, particularly those that are common, costly, and responsive to lifestyle changes. The following are just some of the conditions that can be effectively addressed in group visits: Cancer, Asthma, CHF (congestive heart failure), Coronary artery disease, Depression, Diabetes, GERD, Irritable bowel syndrome, Obesity.

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