(3) Multiple visits (inpatient or outpatient).
(a) Multiclinic visits. Multiple visits may be counted if a patient is provided
care in different clinics or is referred from one care provider to another care provider for
consultation and is documented, such as the SF 513. For example, a patient seen at the
primary care clinic and at two other specialty clinics on the same day can be counted as
three visits; or, a patient visiting a clinic in the morning and again in the afternoon can be
reported as two visits. However, in order to count two visits, the first visit must be
completed. For example, the patient must have been evaluated, treated, and
dispositioned, and the required documentation made in the medical records. Only one
visit can be counted if the visit in the afternoon is merely a continuation of the visit in the
morning. For example, a patient seen in the orthopedic clinic in the morning is sent to
radiology for x-rays and returns to the orthopedic clinic in the afternoon for continued
evaluation or treatment. These rules apply even if the patient is admitted to an inpatient
status immediately following a clinic visit. Also, two visits can be counted when an
occupational or physical therapist provides primary care (patient assessment while serving
in a physician extender role) and subsequently refers the patient for specialized treatment
in the same clinic on the same day.
(b) Group visits. Only the primary provider of group sessions may count
one visit per patient.
(c) Multiprovider visits. When a patient is seen by more than one
healthcare provider in the same clinic for the same episode of care, only one visit is
counted per patient. If the patient requests a second opinion, a visit can be counted
provided the criteria in paragraph f are met.
g. Services Not Reportable As Visits.
(1) Occasion of service. Without an assessment of the patient's condition or the
exercise of independent judgment as to the patient's care, screening examinations,
procedures, or tests are classified as an "occasion of service" because they do not meet
the criteria of paragraph f.
(2) Ward rounds/grand rounds. Ward rounds and grand rounds are considered
part of the inpatient care regimen and are not counted as inpatient visits. Visits by an
inpatient to an outpatient clinic for the convenience of the provider, instead of ward or
grand rounds, will not be counted.
(3) Group education and information sessions. Group education and
information sessions that do not meet the criteria in paragraph f will not be counted.