Understanding When & How to Report New Add-on Code G2211

Description

Although G2211 is not a new code, it has been in inactive status until January 1, 2024, when it moved to active status, thus making it reimbursable.  Since that time, many questions have arisen about the proper use, who may report the code, and when it is not appropriate.  Medicare issued guidance in January, 2024 in their Medicare Learning Network article number MM13473.  This article provides clarity about use of the code.

Any provider who can bill Medicare for office visits & outpatient Evaluation & Management services can bill G2211.  However, key to proper use is the provider’s relationship to the patient.

The provider must serve as the contunuing focal point for all of the patient’s health care services needs.

The physician provides ongoing medical care related to a patient’s single, serious condition or complex condition.

These 2 guidelines require that the physician build a longitudinal relationship over time.  Additionally, the physician will address the majority of a patient’s health care needs consistently & continually over time.

The purpose of G2211 is to improve costs associated with the complexity of logitudinal care.  Medicare allowable in 2024 for G2211 is $16.04.

Webinar’s Goals:

1. Clarify who can bill G2211
2. When it is appropriate to report G2211
3. When it is inappropriate to report
4. Supporting documentation
5. Review examples of G2211

Target Audience:

• Revenue Cycle Managers & staff
• Billers
• Coders
• Clinical Documentation Staff
• Finance Managers
• Denial Management Staff
• Physicians
• Mid Level Providers
• Claims Follow Up Staff