G2211 Resource Center

Since 2024, CMS has paid G2211 as an add-on with office and outpatient E/M visits, CPT 99202–99205 and 99211–99215. It is not a standalone visit code. The CY 2024 Physician Fee Schedule final rule, which the firm’s March 2024 note discusses at 88 FR 78979, ties the add-on to the relationship: the practitioner is the continuing focal point for the care the patient needs, or the visit is part of ongoing care for a single, serious, or complex condition.

CMS’s own example is a sinus visit with the primary care practitioner who remains responsible for the rest of the patient’s care. The complexity is the ongoing responsibility, not the congestion. A second example in the firm’s note is ongoing specialty care for a serious condition, such as HIV care with an infectious disease physician.

The moratorium in the Consolidated Appropriations Act of 2021 ended December 31, 2023. The firm’s January 2021 note explains that delay. Do not use it as a current billing rule.

Effective January 1, 2025, CMS allowed payment for G2211 when certain Part B preventive services are furnished the same day, including an annual wellness visit, vaccine administration, or other Part B preventive services in the office or outpatient setting. The firm’s note cites CMS Transmittal 13015 and the revised MLN article MM13473.

For CY 2026, CMS allows G2211 with home or residence E/M visits, in addition to the office and outpatient codes. Read the January 2026 billing update for the code range before you add it to a home-visit charge.

It will not tell you that a particular encounter supports G2211. That depends on the relationship and the note. It will not quote a dollar amount; use the current CMS Physician Fee Schedule for payment. If a reviewer has already asked about the code, use the documentation note and the payor-audit center, then the coding practice page if you want counsel on the sample.