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

Related CR Release Date: January 18, 2024
MLN Matters Number: MM13473 Revised
Effective Date: January 1, 2024 & January 1, 2025
Related Change Request (CR) Numbers: CR 13473 & CR 13705
Implementation Date: February 19, 2024 & January 6, 2025
Related CR Transmittal Numbers: R12461CP & R13015OTN

Note: CMS added information on how to use G2211 with modifier 25 for certain Medicare Part B services starting January 1, 2025 (pages 2, 3 & 4). CMS also added the CR 13705 effective & implementation dates, transmittal number, and link. Substantive content changes are in dark red.

CR 13473 tells you about:

  • Correct use of HCPCS code G2211 and modifier 25
  • Documentation requirements for G2211
  • Patient coinsurance and deductible
  • How to use G2211 with modifier 25 for certain Part B services

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)13473.

Last Updated Jan 14 , 2025