Billing CPT Codes for Group Visits

When you participate in a group visit there are some CPT codes that are involved in this type of service that you often see.  These codes have been established by CMS since 2018.  The purpose of this FAQ is to explain some of the codes that we commonly use for group visits that you may see billed to your insurance depending on your particular service.

CPT code G2212 or 99417

These codes indicate that you participated in a group visit or had a service provided that was longer than 55 minutes.  Please be advised that per current coding guidelines the time that that a provider spends prior to and after your service (for example reviewing your chart and documenting your service) is included in your service time if completed on the same date as your face to face time.  Typically when having a group visit they are usually 90+ minutes so this is a common code that is seen on these types of visits.

CPT code 99358

Many patients participating in our group visits often are doing homework and journaling as part of their care plan and the doctor typically reviews this information and provide direct feedback in between visits.  This is a billable service to your insurance if the time the the doctor spends doing this service is >31 minutes per episode (i.e. each time it is performed).  This is also a common code that is billed in between visits

CPT code 99423

This cpt code indicates that an online service was provided to the patient that was initiated by the patient via an electronic means (i.e. patient portal, support desk or student dashboard).  This code can be billed anytime a service is provided that was initiated by a patient's online request or question.