Use of Evaluation, Management Add-On Code G2211 Remains Below Projected Adoption Levels

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By Elana Gotkine HealthDay Reporter

Medically reviewed by Drugs.com

via HealthDay

WEDNESDAY, April 8, 2026 -- Use of the new Centers for Medicare & Medicaid Services evaluation and management (E/M) add-on code, G2211, which was established to better account for previously uncompensated costs of longitudinal, nonprocedural care for complex or chronic conditions, gradually increased through mid-2025, stabilizing at 27 percent, according to a study published online April 7 in the Annals of Internal Medicine.

Joshua A. Smith, M.D., M.P.H., from the Robert Graham Center for Primary Care Policy Studies in Washington, D.C., and colleagues characterized G2211 use by specialty and payer in a retrospective study of outpatient visits between January 2024 and September 2025 in the Epic Cosmos dataset.

The study included 377,972,752 E/M visits billed to Medicare, Medicare Advantage, Medicaid, and commercial payers (22.3, 20.3, 6.0, and 51.4 percent, respectively). The researchers found that 5.0 percent of Medicare E/M visits included G2211 in January 2024. By December 2024, the Medicare utilization rate reached 19 percent. In 2025, utilization continued to increase, stabilizing near 27 percent midyear. Utilization of Medicare Advantage tracked closely with Medicare. During the study period, commercial use never surpassed 12 percent. Endocrinology and internal medicine used G2211 most frequently within Medicare (46.6 and 39.7 percent of E/M visits in September 2025, respectively). Dermatology had the lowest utilization among specialties examined, with the code used in less than 20 percent of Medicare E/M visits.

"Overall, clinicians providing longitudinal care have used G2211, though use in this cohort seems to be substantially below projected full adoption levels," the authors write.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

Source: HealthDay

Posted : 2026-04-09 02:11

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