A primary care provider delivering services through group appointments approached us for a full compliance review of their Medicare billing. While Medicare generally does not support billing for group consultations, this provider’s model was highly specialised and unlike anything we had seen before.
We undertook a detailed legal and billing analysis, reviewing the relevant legislation, Medicare rules, and supporting materials. Our conclusion: with some targeted adjustments, the model could be brought into alignment with Medicare requirements. As long as specific legal and documentation criteria were strictly followed, billing for the group appointments could proceed lawfully.