Advice on reimbursement for group visits

If physicians, midlevel providers, or nurses participate in the group visits, they can be reimbursed in exactly the same way as they would be for individual appointments.


Group visits are a highly effective and efficient way to enhance diabetes management and self-management support.

If physicians, midlevel providers, or nurses participate in the group visits, they can be reimbursed in exactly the same way as they would be for individual appointments. Just as in individual appointments, documentation must match the billing code used. Vital signs and other routine data should be charted. Clinicians participating in the visit must create a progress note, and an ICD-9 and CPT code for each patient service must be entered on an encounter form.

The following CPT codes are generally used for follow-up appointments conducted as group visits: 99212, 99213, 99214, and (sometimes) 99215, depending on the level of service rendered. Several excellent resources provide step-by-step guidance in planning and implementing a group visit for your patients with diabetes. One comprehensive guide is “The Group Visit Starter Kit: Improving Chronic Illness Care,” which is available free of charge online.

From the ACP Diabetes Care Guide.