There is a lot expected of primary care. It is well-established that primary care office visits are more complex than those conducted by other specialties. Primary care practices manage a patient’s complete array of acute and chronic conditions, provide preventive services and counseling, coordinate with specialist and ancillary providers, and address behavioral health challenges and unmet social needs.
Historically, evaluation and management coding has failed to account for the additional complexity and related practice costs related with servicing the needs of complex patients. To remedy this, Medicare has introduced a new code, G2211, to address this complexity. The new code is focused on appropriately valuing “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.”
To assist practices with understanding the new code and its requirements, Medicare Learning Network (MLN) has published a great new resource called How to Use the Office & Outpatient Evaluation and Management Visit Complexity Add-on Code G2211. It is a helpful learning tool to better understand the new code. After all, CMS projects that G2200 will accompany 38% of all E&M visits initially, and 54% of all E&M visits when fully adopted.
Michigan Multipayer Initiatives 