G2211 (Visit Complexity Add-on)
Medicare HCPCS add-on code recognizing the visit complexity inherent to evaluation and management services associated with primary care and certain longitudinal care.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 2
- Workspace handoff
- revenue audit →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS MM13473 implemented G2211 effective January 1, 2024 (paid). It attaches to office/outpatient E/M (99202-99215) for longitudinal primary or principal care relationships, with payer-specific exclusions when modifier 25 is appended.
How it shows up in your practice
Append G2211 to qualifying E/M visits when the practitioner is the continuing focal point of care. Cannot be billed with most preventive medicine visits or when modifier 25 is on the same encounter (per the current CMS policy).
Sources
- CMS — HCPCS G2211 (Visit Complexity Add-on)https://www.cms.gov/files/document/mm13473-implementation-hcpcs-code-g2211-visit-complexity-add-code-relating-evaluation-and-management.pdf
- CMS — Physician Fee Schedule (PFS)https://www.cms.gov/medicare/payment/fee-schedules/physician
Check G2211 capture in Revenue Audit
Open revenue audit →Related terms
- CodingE/M CodingEvaluation and Management codes (99202-99499) used to bill office, hospital, and other professional visits.
- BillingModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- BillingChronic Care Management (CCM)Care management services for Medicare beneficiaries with two or more chronic conditions; billed monthly under CPT 99490 and related codes.
- BillingCPT (Current Procedural Terminology)The AMA-maintained code set that describes medical, surgical, and diagnostic services for billing.
- BillingHCPCS Level IIThe CMS-maintained code set covering products, supplies, and services not included in CPT — primarily durable medical equipment, drugs, and Medicare-specific services.
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Related across the archive
- GlossaryHCPCS Level IIThe CMS-maintained code set covering products, supplies, and services not included in CPT — primarily durable medical equipment, drugs, and Medicare-specific services.
- GlossaryChronic Care Management (CCM)Care management services for Medicare beneficiaries with two or more chronic conditions; billed monthly under CPT 99490 and related codes.
- GlossaryCPT (Current Procedural Terminology)The AMA-maintained code set that describes medical, surgical, and diagnostic services for billing.
- GlossaryModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- BillingModifier 25: When to Use It and Common MistakesWhen to use modifier -25, when to skip it, and the common mistakes that trigger audits and denials.
- GlossaryE/M CodingEvaluation and Management codes (99202-99499) used to bill office, hospital, and other professional visits.
- GlossaryCardiac Stress Test (93015-93018)CPT codes for cardiac stress testing, with separate codes for the global service, supervision, and interpretation.
- GlossaryCharge CaptureThe process of identifying and recording every billable service furnished during a patient encounter.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.