G0686 and G0687: Medicare's group visit codes for 2027
A plain-English guide for practices, based on the CMS calendar year 2027 Physician Fee Schedule final rule (CMS-1848-F). The codes take effect January 1, 2027.
Updated November 9, 2026
What the codes pay
Both codes pay per patient, per session. Rates below are the 2027 Medicare allowed amounts, which include the patient's 20% share.
| Code | Covers | Northern NJ | Rest of NJ | National |
|---|---|---|---|---|
| G0686 | First 60 minutes, office rate | $126.78 | $121.75 | $114.86 |
| G0687 | Each additional 30 minutes, up to 2 per session, office rate | $47.27 | $45.76 | $43.40 |
| G0686 | First 60 minutes, facility rate (hospital-based clinics) | $78.49 | $76.37 | $72.76 |
2027 conversion factor $32.63. G0686 carries 1.73 work RVUs; G0687 is valued at half of G0686's work RVUs and was added in the final rule after public comments.
One hour, 8 patients
8 × $126.78 = $1,014 in Medicare allowed amounts for a 60-minute group in Northern NJ. A 90-minute session adds $47.27 per patient.
The same hour, one-on-one
Three 99213 visits come to about $305 in Northern NJ. Nationally, a 99213 is $92.02 and a 99214 is $131.17. A group of 3 already pays more than an hour of one-on-one visits.
The rules
Who leads and bills
A physician or other qualified health professional leads the session and bills for it. Other professionals, clinical staff or auxiliary personnel can help under the billing clinician's direction.
Who can attend
- 2 to 10 patients who share one or more medical conditions.
- Established patients only: seen by the billing practitioner, or a same-specialty colleague in the same group, in the prior 12 months.
- Participation is voluntary.
- Consent and confidentiality terms are documented, including that patients don't share other participants' information.
What a session includes
Group education, counseling and peer support, combined with an individualized clinical assessment and care for each patient.
How often
- Billed once per patient per session.
- No more than one group visit per patient per week.
- A session can run up to 120 minutes: G0686 plus up to two units of G0687.
Which conditions
CMS did not publish an exhaustive list. It describes group visits as suited to conditions that can be modified with lifestyle change. Conditions commenters raised, including tobacco use disorder, alcohol and other substance use disorders, obesity and behavioral health conditions, are not ruled out to the extent they can be modified with lifestyle change.
Telehealth
Both G0686 and G0687 are on Medicare's 2027 telehealth list. Patients can join from home through December 31, 2027, under current telehealth rules.
Which place-of-service code to use, and therefore whether the office or facility rate applies, for patients joining from home is still being confirmed. Check with your Medicare contractor before you bill.
What patients pay
Group visits are Part B services, so the usual cost sharing applies.
- Before the Part B deductible is met, the patient pays the full allowed amount, about $127 for a 60-minute session in Northern NJ.
- After the deductible, 20% coinsurance: about $25 per 60-minute session in Northern NJ.
- Often $0: patients whose Medigap plan covers coinsurance (such as Plan G, after the deductible), many with both Medicare and Medicaid, and, from April 1, 2027, patients in ACOs approved to waive Part B cost sharing.
- Medicare Advantage: copays are set by each plan.
Still open
The final rule leaves these questions unanswered. Ask your Medicare contractor (Novitas Solutions in New Jersey) or a certified coder.
- Place of service for patients at homeWhich code applies, and so which rate.
- Clinician presenceWhether the billing clinician must attend the whole session. Plan on it until your contractor says otherwise.
- Rural health clinics and FQHCsWhether they can bill the new codes.
- Medicare Advantage and commercial plansWhether each plan covers the codes, and what patients will pay.
- Behavioral healthHow contractors will judge "modifiable with lifestyle change" for conditions such as depression.
Source: CMS CY 2027 Physician Fee Schedule final rule, group medical session section (public inspection PDF, pages 348 to 369), with payment amounts from Addendum B. This guide is a summary, not billing advice.
Want the codes without the paperwork?
We set up the groups, consent, notes and claim worksheets so your practice can bill G0686 from the first session.