- What is Group Prenatal Care?
Group Prenatal Care (GPC) is a model of prenatal care facilitated by a trained healthcare provider (obstetricians, certified nurse midwives, or other obstetric care providers), delivered in a group setting, which integrates health assessments, education and skills building, and peer social support.
- How many pregnant individuals can participant in a Group Prenatal Care session?
Group Prenatal Care sessions generally include 8 to 10 pregnant patients of similar gestational age.
- What are the requirements that must be met to provide Group Prenatal Care?
The following are requirements for Group Prenatal Care (GPC):
- Effective for dates of service on or after December 1, 2023
- 8 to 10 sessions conducted every 2 to 4 weeks
- Led by trained facilitators (obstetricians or other obstetric care providers) who are trained facilitators of an evidence based GPC model
- 8 to 10 pregnant patients of similar gestational age
- Each session should be at least 90 minutes
- Participants may receive up to 10 GPC visits per rolling year
- Which providers can bill for Group Prenatal Care sessions?
Any provider who can bill for a prenatal visit including medical doctors, nurse practitioners and certified nurse midwives, who are trained facilitators of an evidence based Group Prenatal Care (GPC) model. However, the idea of GPC is that the provider is conducting the sessions with a second person who might be a therapist or doula, and the enhanced reimbursement to the provider can cover that person’s time in co-leading the group.
- How many Group Prenatal care sessions can a provider bill for a pregnant patient?
Participants may receive up to 10 Group Prenatal Care (GPC) sessions per rolling year. GPC can be billed per participant, per session. Only one provider may bill for a GPC session. GPC visits are billed in addition to regular obstetric services.
- How does a provider bill for Group Prenatal Care?
Providers must submit a claim for each Group Prenatal Care (GPC) visit using Current Procedure Terminology (CPT) code 99078 with modifier TH. Providers are able to bill the GPC code, in addition to the standard prenatal visit code on the same date of service.
GPC can be billed per participant, per session. Only one provider may bill for a GPC session. GPC visits are billed in addition to regular obstetric services.
- What curriculum should a provider use for Group Prenatal Care sessions with pregnant patients?
Providers may use any evidence-based curriculum and can also modify an evidence-based curriculum in order to serve a specific population.
EleVATE is able to work with sites wanting to implement the EleVATE program in Missouri. They offer training, coaching, help with implementation and access to materials.
CenteringPregnancy and March of Dimes are national models and also offer group prenatal care trainings, coaching, help with implementing group prenatal care and access to materials.
- Are there things that a provider must do at a Group Prenatal Care session?
The clinical component should be identical to what a provider would do for a pregnant patient attending a prenatal visit. The key activities of the group model still include the same care that would happen at a traditional prenatal visit.
- Does the same provider have to bill for each session of Group Prenatal Care visits?
No, providers may bill for the Group Prenatal Care sessions they facilitate.
- Can pregnant patients go to both individual prenatal visits and Group Prenatal Care sessions?
The preferred way to access the benefits of Group Prenatal Care (GPC) is for all sessions to be part of the group model. The ongoing psychosocial support from the group setting is best achieved through consistent participation in the group. Providers should adhere to an evidence-based group prenatal model.
- Can Group Prenatal Care be done using a telehealth format?
Group Prenatal Care visits may include monitoring vital signs, urine tests, blood tests, physical exams, and listening to the baby’s heartbeat. These require an in-person visit as the telemedicine visit could not provide the same standard of care.
- What should a provider do if less than eight pregnant individuals attend a Group Prenatal Care session?
Although it is preferable to have 8 to 10 pregnant patients of similar gestational age at Group Prenatal Care sessions, there is no set minimum. The provider should only bill for the number of pregnant participants at a session.