From the Coding Corner: CMS Releases FAQ on Code G2211

On January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the implementation of the evaluation and management (E/M) add-on Healthcare Common Procedure Coding System (HCPCS) Code G2211. The creation of this code was based on the need to account for resource costs associated with E/M visits and also patients’ longitudinal care. It is meant to be considered as an additional payment, acknowledging costs associated with the practitioners’ principal role of providing needed services that are part of the ongoing, longitudinal care relationship related to a patient’s single, serious condition or complex condition.

With this code’s recent creation and many questions around appropriate usage, CMS recently released a comprehensive document in a FAQ format meant to answer and provide guidance on its functionality and appropriate utilization.

The newly released CMS FAQ document answers questions related to use of the new add-on code and Modifier 25, documentation requirements, diagnosis codes, definition of longitudinal care and much more.