Login
In 2024, there is a new code that has had much discussion related to ‘appropriate use’. This discussion included a number of publications from the American Academy of Pediatrics. Based on the guidelines and discussions, below is the basic information related to this new 2024 code.
What is this code for?
This code was established to encourage patients/families to use their Primary care office versus urgent care or emergency rooms for sick visits. The code was created to help ‘fairly’ compensate primary care offices for sick visits that are patients they manage.
When should this code be added?
Sick visits without other procedures (e.g. vaccines). Note that neither the E/M nor code g2211 should use modifier 25.
Is G2211 covered/reimbursed by payers?
Recommend checking the payor reimbursement policies to confirm coverage and/or reimbursement rate for this code. Note that some payers will ‘bundle’ the service with the sick visit code while some might cover but make this part of the deductible.
