Medicare Payment and Regulations Resources

Medicare’s New Add-on Code 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. G2211 will allow clinicians to account for services like chronic disease management tracking, review of consultative or diagnostic reports, and medication monitoring. CMS created this new code to capture these previously unrecognized elements of continuous, longitudinal care based on a clinician's relationship with a patient. Beginning on January 1, 2025, CMS will 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.

Office and outpatient E/M visits can serve as the continuing focal point for all needed health care services, making them comprehensive and often complex. For more information on the use and reimbursement for G2211, members should review ACP’s informational sheet, video supplement, and the Outpatient Services learning module in the Coding for Clinicians series. As part of ACP’s Coding for Clinicians subscription series, members should be on the lookout for updates to the learning module on G2211 which will go into greater depth and cover additional aspects of billing and reimbursement.

ACP continues to work with CMS to ensure clinicians are receiving reimbursement, additional guidance is widely available to all clinicians and their teams, and the code is covered across Medicare and Medicare Advantage payors as appropriate.