HCPCS Code G2211 is a Bundled Service and Not Separately Paid

Medicare Administrative Contractors are denying separate payment for HCPCS code G2211 ("Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition. (Add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established.")). Under Section 113 of the Consolidated Appropriations Act, HHS is not paying for this code under the Physician Fee Schedule until January 1, 2024. HCPCS code G2211 is a bundled service. Medicare Administrative Contractors will automatically reprocess claims that were paid. You don’t need to do anything.

Last Updated: 02/01/2021