How to Use G2211 Correctly: Billing, Documentation and Compliance for 2025

Description

As of January 1, 2024, Medicare began offering separate payment for CPT G2211, a code designed to reflect the added complexity of ongoing, condition-focused care. In Medicare billing for 2025, this add-on code plays a vital role in supporting clinicians who serve as the consistent, long-term point of contact for patients with a single serious or complex health condition.

According to the Centers for Medicare & Medicaid Services (CMS), CPT G2211 isn't tied to any specific specialty. While certain specialties may report it more frequently, the code is available to all providers when they're actively managing a patient's condition through continuous, collaborative care. This includes activities like patient education, setting mutual goals, clarifying roles, and engaging in shared decision-making—all of which should be clearly documented in the patient’s medical record.

However, not all visits qualify. G2211 is not appropriate for routine or one-time services, such as minor procedures (like mole removal), seasonal allergy advice, simple viral infections, or injuries like fractures—especially when there’s no plan for continued care. The code also cannot be billed if the E/M visit is reported with modifier -25, or with modifiers -24 or -53, which typically indicate care unrelated to ongoing treatment. In short, CPT G2211 is meant for visits that reflect a deeper, long-term clinical relationship—not one-off encounters.

It’s also important to know when not to report this code. G2211 cannot be billed on its own and is not valid with certain eye visit codes, such as 92002, 92004, 92012, or 92014. If you're using time-based E/M codes and the visit exceeds the required time for a level 5 visit, you should instead report prolonged services with G2212, not G2211.

As part of medical coding in 2025, staying current on how and when to use CPT G2211 is essential. The code can be used across both primary and specialty care settings, provided the visit involves active, coordinated management of a complex or serious condition. Just be sure to check your Medicare Administrative Contractor (MAC) policy before billing, as coverage may vary by region.

Ultimately, CPT G2211 supports more accurate reimbursement for the clinical time and effort involved in building long-term care plans. For providers focused on consistent, high-quality care over time, it’s a valuable addition to the coding toolkit.

Areas Covered

• Explore the intent and background behind CPT G2211 to understand why it was developed and how it's meant to support care continuity.
• Review the latest updates for 2025 from CMS and commercial payers, including evolving billing expectations and guidance.
• Analyze real-world case studies that show both appropriate and inappropriate uses of G2211 to better distinguish when the code applies.
• Learn key documentation do’s and don’ts based on an auditor’s G2211 compliance checklist to support accurate reporting and reduce audit risk.
• Identify the top denial reasons associated with G2211 and discover proactive strategies to avoid them, ensuring smoother billing in the landscape of Compliance 2025.

Why Should You Attend

Although CMS developed G2211, many providers have found the guidance around its use to be vague and lacking clarity. This webinar is designed to bridge that gap by exploring the history and intent behind the code, breaking down the essential concepts for accurate reporting, and highlighting real-world clinical examples.

You'll also gain insight into potential compliance risks and practical G2211 coding tips that can help you apply the code correctly in day-to-day practice. Whether you're in primary or specialty care, this session aims to bring clarity and confidence to your use of G2211.

Who Should Attend

• Coders
• Billers
• Providers
• Revenue Cycle Professionals
• Auditors

Speaker: Dawson Ballard

Dawson Ballard, Jr. is a highly respected leader in the medical coding field, holding over 20 years of hands-on experience in CPT codes, ICD-10-CM, and HCPCS coding, auditing, and education. With a deep passion for his profession—often referring to himself as a proud “coding nerd”—Dawson provides consulting services for healthcare providers with a strong emphasis on E/M coding, risk adjustment, and ICD-10-CM, spanning specialties such as OBGYN, Family Practice, and Internal Medicine.

Dawson holds multiple industry-recognized credentials including RHIA, CCS-P, CPC, CPMA, and is an AAPC Fellow, recognized for his extensive experience and continued contributions to the coding profession.

He remains an active member of AAPC and AHIMA, contributing through published articles, serving as a local chapter officer, and participating as a board member for his AHIMA State Component Association. Dawson has also delivered numerous educational presentations on medical coding topics at both local and state levels.

His dedication to the profession and commitment to excellence continue to shape and support the healthcare coding community nationwide.

After Registration: Once you register, you will receive a confirmation email with login credentials and access to presentation materials. These resources are downloadable and may be shared with team members at your location for training.

System Requirements:

● Internet: A stable internet connection with a speed of at least 1 MBPS is recommended.

● Audio: A functioning headset or speaker with a microphone is encouraged for interactive sessions and a clear audio experience.

Session Cancellation Policy:

If for any reason ConferencePanel must cancel or reschedule the session, registered participants will be notified via email no later than 24 hours before the session start time.

Can’t Attend the Live Webinar?

No worries. ConferencePanel offers On-Demand access to many of its healthcare compliance and reimbursement webinars. If you're unable to join the live session, you can still benefit from the content at your convenience. For assistance with access, feel free to contact us:

Toll-Free: +(877) 629-3710Email: support@conferencepanel.comAddress: 440 N BARRANCA AVE #9306 West Covina, CA, US 91723

What Attendees Are Saying:

“ConferencePanel's webinar was well-organised and delivered practical insights our clinical team could act on immediately. The speaker was engaging and addressed all our concerns during the Q&A session.”– Laura M., Compliance Officer, Regional Healthcare System

“I appreciated how easy it was to join and follow the session. The materials provided were professional and informative, and I was able to share them with my entire billing staff.”– Raj D., Revenue Cycle Manager, Private Practice Group