MAY 07, 2024
Are We Able to Bill G2211 to Medicare Advantage Plans?
Are we able to bill G2211 to Medicare Advantage plans?
Answer:
When implemented, HCPCS code G2211 was payable by Medicare Part B initially, and the RVU value was determined by the Centers for Medicare & Medicaid Services (CMS) and not the RUC. Medicare Advantage, commercial, or Medicaid plans may start adopting coverage policies for HCPCS code G2211. Confirm with the insurance payer.
Based on available CMS guidance the Academy offers this coding clue in its fact sheet:
- Medicare Part B pays separately starting Jan. 1, 2024. Coverage is at the Medicare contractor’s discretion. Verify each unique Medicare administrative contractor (MAC) policy.