Table 1

Conversation Group Medical Visit Structure

Structural ElementContent
 SessionsTwo sessions, 1 month apart
 PatientsGoal of 8 to 12 patients per cohort
 Practice settingA practice able to coordinate group medical visit processes as a clinical team.
 LocationClinic conference room
 Optional resourcesPatient handouts; video projector; white erase board; water
Facilitator considerationsFacilitators need to represent 2 disciplines (physician and social worker).
One needs to be a physician, physician assistant or advanced practice nurse able to bill for the medical visit.
Facilitators must be able to facilitate a group and engage patients in behavior change.
Facilitators must be knowledgeable in advance care planning.
Group visit session format2-hour sessions formatted as follows:
Arrival, check-in, medical update (30 minutes)
Introductions and rapport building (20 minutes)
Advance care planning discussion using a communication guide and decision aids (60 minutes)
Individual goal-setting (10 minutes)
Optional: Workshop time to complete advance directives
Optional: Individual clinical visits (10 minutes)
Documentation and billingDocument any individual evaluation and management services provided (typically CPT code 99213).
Update record with surrogate decision maker(s), care preferences, advance directives, medical orders for scope of treatment, code status preference as needed.
Communicate advance care planning preferences with primary care provider.
  • CPT = Current procedural terminology.