G2211 delayed until 2024

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The Consolidated Appropriations Act, 2021 has modified the Medicare Physician Fee Schedule (MPFS).  Two major impacts under the Act include:

  • A 3.75% increase in MPFS payments for CY 2021
  • Delayed implementation of the inherent complexity add-on code for evaluation and management services (G2211) until CY 2024.

Additionally, the conversion factor was revised to reflect the 3.75% increase.  The CY2021 conversion factor is now 34.8931.

G2211 was finalized in the MPFS final rule as an add-on code to E/M services.  G2211 was to capture visit complexities of service related to ongoing care to a patient’s single or complex condition.  The code was designed to be used in addition to an E/M service and also available for telehealth.  The estimated reimbursement was approximately $11-15.

Practices may have configured their 2021 charge system and EMRs to capture the new code.  Due to the Act, the implementation of this currently delayed until 2024.