We have received questions left and right regarding the new Medicare add-on code +G2211 – for complexity and serious condition provider/patient long-term relationship care.

We discussed this code in September 2023, when it was a CMS proposal, but now that it is effective let’s look at the realities. The Modifier -25, when reported on an E/M claim with the G2211 will be denied.

But what about the NCCI edits when you can’t avoid the 25 modifier, such as adding, immunizations or preventative services? Will you still see denials of the G2211? Can NPP’s report this add-on? What conditions can be considered? What providers and specialties can report this code?

Tune in this week as Terry provides some answers to these questions and more.

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