Wiki Billing for group wellness visits

[cchrisjohn]

I was wondering if I could get some assistance. One of our docs is wanting to start doing wellness group visits. What I have read is that she can bill 99201-99215 for these group visits and then there are some other codes that a non-practitioner can bill for when she counsels the patient. I can't find much information about this and was going to see if you could give me any advice on where I can gain knowledge on how you would code these visits correctly. I also need to know what the documentation guidelines are. My doc was saying that she wanted to document these visits with a check list. I was also interested to see if we could maybe use a preventative code so that the patient's co pay might be able to be waived? Like I said I personally don't know much about billing for something like this, thank you in advance for helping.

 

[mitchellde]

As far as i am aware there is no code for group wellness, and i am not sure how the provider could pull that off and maintain confidentiality. Each patient would need to be examined individually which makes it not a group. And Medicare says no to check sheet documentation. You cannot use 99201-99215 for wellness and i have never read where these can be use for a group of patients.

 

[Kisalyn]

This sounds a little bit like what our nurse coaches do, except patients are seen individually. We have one in each clinic and our phsyicians send their patients to them to provide wellness education. They monitor the patient's numbers (weight, INR, BG levels) and follows up with them as needed. This is by phone and by appointment.

Nothing is billed out. It's just part of the service the clinics offer to manage chronic conditions and promote wellness.

 

[jfree104]

For the purpose of promoting health and preventing illness or injury use Preventive Medicine, Group counseling, without a specific illness, 99411 (approx 30 minutes) and 99412 (approx 60 minutes). May not be covered by all insurance plans.