HCPCS Code G2211 is a Bundled Service & Not Separately Paid
In the Medicare Physician Fee Schedule (MPFS) final rule, CMS created add-on code G2211 to report visit complexity for E/M services. This is based on their on the belief that codes 99202-99215 do not adequately capture the resources associated with patient care in some specialties:
+G2211 – Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition. (List separately in addition to office/outpatient evaluation and management visit, new or established).
Medicare Administrative Contractors are denying separate payment for this HCPCS code and are considering it a bundled service. Under Section 113 of the Consolidated Appropriations Act, HHS is not paying for this code under the Physician Fee Schedule until January 1, 2024. Medicare Administrative Contractors will automatically reprocess claims that were paid.
To review the CMS update, click on the link: MLN Connects 020421-Code G2211
