We understand the challenges of keeping current on coding and billing for your Medicare patients appropriately. Below are resources to help you ensure that you are paid appropriately and do not violate any Medicare policies.
What’s New
Telehealth: In CY 2025, several changes were made to the coding and payment of telehealth services. CPT codes 99441-99443 are no longer available. Physicians should use existing E/M codes (99202-99215) with a –93 modifier for audio-only services and a –95 modifier for audio/visual services. Additionally, CPT code 980216 has replaced HCPCS code G2012 for virtual check-ins.
G2211: Starting January 1, 2024, CMS implemented the new Medicare add-on code G2211 to better recognize and reimburse the resources necessary to provide patients with longitudinal, continuous care. CMS created this code to capture these previously unrecognized elements of continuous, longitudinal care based on a clinician's relationship with a patient. The code was recently updated to allow payment of the G2211 add-on code when reported by the same clinician on the same day as an annual wellness visit, vaccine administration, or any Medicare Part B preventive service. More information on G2211 can be found in ACP’s Coding for Clinicians subscription series.
Quality Payment Program (QPP)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program (QPP) to transition physicians away from a volume-based system toward one that rewards value.
Learn moreTelehealth Guidance and Resources
Offering guidance on clinical use cases, technology, regulations and waivers, and billing and coding.
Getting Started with Medicare
- Medicare Enrollment Resources
- Web-based Training (WBT) Courses: Free tools from CMS that allow doctors and their staff to learn about a broad range of Medicare-related issues.
- Manage Medicare Enrollment - Withdrawing or Opting Out of Medicare
ACP Medicare Payment Advocacy
- ACP Comments on 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule
- ACP Summary of 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule (ACP login required)
- ACP Comments on Proposed 2024 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Rule
- ACP Summary of 2023 Medicare Physician Fee Schedule (MPFS) & Quality Payment Program (QPP) Final Rule (ACP login required)
- Read ACP’s Comments on 2023 Final Physician Fee Schedule & Quality Payment Program Rule
- ACP Advocacy: Improving Medicare