Service Line Guide: Shared Medical Appointments (SMA)

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Supported Line of Business: Commercial & Medicare Advantage

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Evaluation & Management visits delivered to multiple patients in a shared setting — billed individually per patient under standard E/M codes.

Overview

Shared Medical Appointments (SMAs) — also called Group Medical Visits — are individual E/M visits delivered to multiple established patients in a shared setting. A clinician provides each patient with their own discrete, face-to-face 1:1 encounter; group education and discussion are supplemental.

SMAs are not Group Therapy. The key distinction: each SMA patient must receive a medically necessary 1:1 encounter with the billing provider. Pure group education alone is not a billable E/M.

Dimension	Shared Medical Appointments	Group Therapy (90853)
Billing code	99202–99215 per patient	90853, one unit per patient per day
Level driver	Medical Decision Making (MDM) per individual patient	Single code regardless of complexity
1:1 requirement	Required — discrete face-to-face 1:1 portion with each patient	Continuous group facilitation; no individual 1:1 required
Provider types	MD/DO, NP/PA (scope of practice applies)	Licensed behavioral health clinicians
Bridge payer scope	Medicare Advantage + Commercial only	Not yet in scope at Bridge

Consent Requirements

⚠️ SMA requires a distinct written consent beyond the standard telehealth consent. A separate SMA-specific consent form must be completed prior to the patient's first SMA encounter.

The SMA consent must explicitly include:

Acknowledgment that the patient's PHI may be shared with or observed by other patients in the group session
Confidentiality agreement: all group participants agree to keep other patients' information private
Confirmation that the patient understands the shared-session format and consents to receive care in this setting
Standard Bridge telehealth consent terms

When to capture: Prior to the first SMA visit. The consent must be documented in the chart and confirmed in the submitted note:

Consent to treat and consent to SMA services policy will be provided
Must be linked in the patient signup flow and collected with a check box before the visit
Record collection of the consent against the consent API

👋 Work with your Bridge contact to confirm the consent has been configured before scheduling SMA patients.