HMN 2026: How Uptake of new Medicare G2211 code is slower than projected by CMS

A retrospective study of outpatient visits found that use of the Centers for Medicare & Medicaid Services (CMS) G2211 add-on code has grown steadily since inception in 2024 but remains well below federal expectations. By mid-2025, the code appeared on about 27% of outpatient Medicare evaluation and management visits, short of early projections that more than one-third of such encounters would qualify.

The findings suggest that CMS should consider budget and reimbursement implications related to G2211 that are sustainable and adequate for services provided. The study is published in Annals of Internal Medicine.

The G2211 code was implemented to better account for the previously uncompensated costs of longitudinal, nonprocedural care for complex or chronic conditions provided by primary care and other specialties.

Researchers from University of Maryland, Robert Graham Center for Primary Care Policy Studies, and University of California San Francisco used the Epic Cosmos database to review more than 377 million outpatient visits from January 2024 to September 2025 to understand how often clinicians used the new G2211 code across different specialties and insurance types.

They measured the percentage of routine evaluation and management visits that included G2211 each month. They found that Medicare use grew gradually, from 5% of visits in early 2024 to about 27% by mid-2025, while commercial insurers showed lower adoption. Specialties such as endocrinology and internal medicine used the code most often, while dermatology used it least.