Code G2211: Improving practice revenue through the complexity of primary care

Many primary care physicians say one of the best parts of their job is developing relationships with patients and their families, sometimes spanning generations.

Some of those patients arrive at the office with serious, complex conditions. Physicians use their training and experience to assess those conditions and treat patients with short- and long-term interventions.

The Healthcare Common Procedure Coding System (HCPCS) code G2211, which acknowledges that those interventions are not always an easy fix, offers a potential financial boost for doctors.

In Medicare-speak: “HCPCS code G2211 captures the inherent complexity of the O/O E/M visit that is derived from the longitudinal nature of the practitioner and patient relationship.”

This slideshow summarizes information from some key online sources to introduce the G2211 code and explain how it can be a financial benefit to physicians. The Medicare payment rate is approximately $16. That will vary geographically, but this article outlines an example scenario in which a practice could generate more than $32,000 a year by using the code.

To learn more, check out the following resources:

• The American Academy of Family Physicians and its policy affiliate, the Robert Graham Center
• This FAQ list, an MLN Matters information sheet on Code G2211 and another MLN Matters information sheet published by the Medicare Learning Network of the Centers for Medicare & Medicaid Services
• An explanation published by Noridian Healthcare Solutions, a Medicare portal