The application of this code will not result in additional payment for a billed E/M visit service.
A version of this article was first published February 8, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.
In its February MLN Connects newsletter, CMS reminds providers that HCPCS add-on code G2211 (visit complexity inherent to E/M associated with medical care services that serve as the continuing focal point for all needed healthcare 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) is a bundled service under the Medicare Physician Fee Schedule (MPFS), meaning the application of this code will not result in additional payment for a billed E/M visit service.
The new add-on code, which went to effect January 1, accounts for the time, intensity, and resources involved in a provider’s collaboration and continuous care planning with the patient in addition to the visit E/M service (E/M codes 99202-99215).
Under Section 113 of the Consolidated Appropriations Act, the Department of Health and Human Services is not paying for this code under the MPFS until January 1, 2024. Medicare Administrative Contractors will automatically reprocess claims for E/M services that were paid at a higher rate due to the application of this code.
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