G2211: Visit Complexity Add-On Code Effective January 1, 2024

By Jana Holt

Many of you may be aware of the CMS evaluation and management add-on code that was introduced in January of this year. According to CMS, “G2211 captures the inherent complexity of the visit that’s derived from the longitudinal nature of the practitioner and patient relationship”.
 

PDF: How to Use the Office & Outpatient Evaluation and Management Visit Complexity Add-on Code G2211

To help determine if this new add-on code is appropriate for Ophthalmologists to use, the AAO and ASCRS have both published helpful guidance resources.

PDF: AAO G2211: The New Visit Complexity Add-On Code
PDF: ASCRS G2211 Add-On Code Guidelines

Here are some helpful hints for HCPCS add-on code G2211:

• G2211 was created by CMS for the Medicare program.

• G2211 is not limited by specialty.

• G2211 should be added to outpatient and office visit E/M Codes.

• G2211 is not appropriate to be added to Eye examination codes.

• G2211 is not payable when the associated E/M visit is reported with modifier 25