G2211: Add RVUs for the care you already provide

Most of our Medicare patients take up a significant amount of our time and medical decision-making efforts, as their complex conditions take time to manage. Rarely do we have a single concern to address during their office visits in primary care, and in fact, I would argue that the unspoken expectation is that we listen to and act on a list of concerns they have been saving for us for months. It can be both a rewarding feeling (our patients leave the office feeling renewed for another three to six months), and a burden when we have limited time scheduled for them, pushing us to run behind for the remainder of the day.

Effective Jan. 1, 2024, traditional Medicare and many Medicare Advantage plans now recognize our hard work and have provided a new RVU-generating G-code—G2211. At a value of 0.33 RVUs, the G2211 code can be used as an add on to an E/M code during an office visit. This documents the longitudinal relationship you have with your patient, and the complexity of the visit beyond the work of a standard E/M code.

Some quick tips regarding the use of G2211:

Use this code based on your continued responsibility for the patient, not based on the patient’s clinical condition.
CMS will not pay for G2211 when the E/M service is reported with modifier 25, so do not add this code if you are already providing a separate billable procedure or service.
G2211 is attached to E/M codes only, therefore it cannot be attached to Medicare annual wellness visits or transitional care management visits.

Primary care physicians are encouraged to utilize this additional reimbursement opportunity to highlight the continuity of care and longitudinal relationship you have with your patients. Be sure to add this as a quick speed button or favorite in your EMR when coding your visits with Medicare patients and be on the lookout for commercial plans accepting this code in the future. Further details can be found at the following sources.

Sources:

FPM Journal
FP Essentials