G2211 – A Boost to Primary Care and Other Physician’s Revenue Streams, Understanding the Requirements of the Code

The introduction of the G2211 add-on code for office complexity in the 2020 Physician Fee Schedule Final Rule aimed to address the issue of undervaluation of services provided by primary care physicians. Despite its approval, a moratorium was placed on payment for this code until 2024. During this period, further refinements to the HCPCS descriptor were made to clarify its use. The code was designed to account for additional resources associated with a patient's care in a longitudinal nature, which were not adequately captured by traditional office visit codes.

Effective January 1, 2024, the G2211 code became payable as an add-on code to Office and Other Outpatient codes. However, it’s appropriate use was contingent on the relationship between the physician and the patient, as specified in the 2024 Physician Fee Schedule Final Rule. This change aimed to ensure that the code was used in situations where the primary care physician was the "lead" physician for the patient, providing comprehensive and continuous care.

Despite being available for several years, the practical application of the G2211 code can be confusing for healthcare providers. Many offices struggle to understand when and how to use the code, as well as how to document it correctly. This lack of understanding can lead to underutilization of the code and missed opportunities for additional reimbursement for primary care physicians.

To address this issue, this session will provide a comprehensive overview of the G2211 add-on code for office complexity. Participants will gain a deep understanding of the code's background, purpose, and criteria for appropriate use. The session will also offer practical guidance on how to use the code in primary care settings, including best practices for documentation and billing.

By the end of the session, participants will be equipped with the knowledge and skills needed to confidently use the G2211 code in their practices. They will understand the importance of using the code appropriately to ensure proper reimbursement for the additional care elements provided by primary care physicians. Additionally, participants will learn how to document the use of the code effectively, ensuring compliance with Medicare guidelines and maximizing reimbursement for their services.

Webinar Objectives

• Understand the background and purpose of the G2211 add-on code for office complexity.
• Learn the criteria for appropriate use of the G2211 code, including the relationship between the physician and the patient.
• Gain insights into the practical application of the G2211 code in primary care settings.
• Acquire knowledge of best practices for documenting and billing for the G2211 code.

Webinar Agenda

• The origins of the G2211 code will be explained and its journey into becoming a payable code effective January 1, 2024.
• Next, discussion around when to bill this code and what documentation is needed in doing so.
• Who can bill this code is another consideration along with how often the code can be utilized. 
• Finally, modifier use with the G2211 code will be discussed.

Webinar Highlights

• History of the G2211 code
• What did we discover about the code in the 2024 PFS Final rule
• Are there frequency limitations.
• Who can bill the code?
• What documentation is required?
• Where to find more information

Who Should Attend

Coders, Billers, Office Managers, Administrative Assistant, Physicians