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Practice Management Alert

Practice Management:

You Can Use G2211 for Patients Beyond Medicare Beneficiaries

Question: Can I use G2211 for patients regardless of their insurance or only for Medicare beneficiaries?

Minnesota Subscriber

Answer: Code 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. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)) is a HCPCS code that providers may bill to illustrate that the service they provided has a particularly complicated element, but also that the services or time required are necessary for deepening the provider-patient relationship. While, as a G code, it’s considered an add-on code in the HCPCS coding convention and intended for use for Medicare beneficiaries, other insurance carriers may or may not accept claims featuring G2211 and pay accordingly.

Check with the insurance carrier, especially if it’s a commercial carrier, to see whether they accept G2211 on its own or bundle it into other evaluation and management (E/M) services.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC