Billing Medicare for G2211: What You Need to Know Now

Beginning this year, Medicare will make payment under the Physician Fee Schedule for HCPCS G2211, the outpatient intensity add-on code.
The impacts of the code were presented during a PYA webinar on February 7, 2024.
During the webinar, a panel of PYA experts, including Lori Foley, Valerie Rock, Angie Caldwell, and Martie Ross, discussed the requirements for this new code and its financial impact on physician practices. Topics of discussion included:
Services to which the add-on code applies
Who can bill the code and in what circumstances
What practices stand to lose if they don’t bill the add-on code
Documentation
Potential audit risk areas
Approaches to implementation
Potential impact on physician compensation formulas
This webinar was part of PYA’s twice-monthly Healthcare Regulatory Roundup (HCRR), a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. Watch for more HCRR webinars coming soon, and for updates about all of our webinars, check the PYA website and PYA’s LinkedIn page.
If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below or call [phone].

[@azppmd]

Very, very, very nicely conducted and circumspective evaluation of current G2211 landscape.

[@Colossians3.23]

Trying to find National G2211 Private Payer Coverage list. Where can I obtain this (FREE)? Indicating "CMS" covers this code is too vague. Please assist. Thanks.

[@azppmd]

Private payer coverage will be very regional, and is evolving.
I have heard certain BCBS and UHC plans paying for G2211 as of 2024 0323.