Kinfold Health

Group visit revenue calculator

What one Medicare group visit pays your practice in 2027, compared with spending the same clinician time on one-on-one visits. Change the inputs to match your practice.

Where your practice is
Session length

90 minutes bills G0686 plus one G0687 per patient.

8

Medicare allows 2 to 10. Enroll about 10 to have 7 or 8 attend.

Groups per month
2

Each group needs its own patients: a patient can attend at most one group visit a week.

$

Default: three 99213 visits an hour, adjusted to your area (approximate). Enter your own figure.

8 patients = $1,014 a session

Medicare allowed amount for a 60-minute group in Northern NJ, at $126.78 per patient.

Medicare allowed, per session $1,014 8 × $126.78
More than one-on-one visits +$709 vs $305 for the same hour one-on-one
Beats one-on-one from 3 patients the smallest group that pays more

At 2 groups a month

Medicare allowed$2,028$24,342 a year
More than the same time one-on-one+$1,418+$17,022 a year

Kinfold charges a flat fee per session, set in advance. Ask us for pilot pricing.

By attendance

PatientsMedicare allowedvs one-on-one

What each patient pays

After the Part B deductible (20%)$25.36
Before the deductible is met$126.78
Medigap Plan G, many Medicaid duals, ACO waivers$0

The allowed amount includes this share: Medicare pays 80%, and the patient or their secondary coverage pays 20%. Medicare Advantage copays vary by plan.

Rates are 2027 office (non-facility) payment amounts from the CMS CY 2027 Physician Fee Schedule final rule (CMS-1848-F), conversion factor $32.63. G0686 covers the first 60 minutes; G0687 each extra 30 minutes. Hospital-based clinics are paid the lower facility rate (G0686: $78.49 Northern NJ, $76.37 rest of NJ, $72.76 national).

The rate for patients who join by video from home depends on the place-of-service code, which is still being confirmed. This calculator assumes the office rate.

One-on-one comparison: 2027 national 99213 is $92.02 and 99214 is $131.17. The New Jersey defaults scale three 99213 visits by the same area adjustment as G0686, so they are approximate.

Source: CY 2027 PFS final rule, group medical session section. Illustrative only; actual payment depends on your coding, contracts and collections.