Question:
Kansas Subscriber
Answer:
The appropriate code choice depends on how your provider structures the meetings and how many patients are present.Option 1:
If the physician plans and presents the information, you can submit 99078 (Physician educational services rendered to patients in a group setting [e.g., prenatal, obesity, or diabetic instructions]) as he suggests. Note that 99078 is not a time-based code and can be submitted for each patient present during the session. Not all payers reimburse for 99078, however, so check guidelines before making assumptions regarding payment.Option 2:
If a non-physician provider leads the session, you'll report different codes based on the number of patients present. Choices include 98960 (Education and training for patient self-management by a qualified, non-physician health care professional using a standardized curriculum, face-to-face with the patient [could include caregiver/family] each 30 minutes; individual patient), 98961 (... 2-4 patients), and 98962 (... 5-8 patients). Note that the training must use a standardized curriculum in order to report these codes, although you may modify the curriculum, as needed, for the clinical needs, cultural norms, and health literacy of the patient(s).