In 2020, the Centers for Medicare and Medicaid Services developed a new add-on billing code to pay physicians for care coordination and other services necessary to provide comprehensive, longitudinal care to complex patients. Before the code could be implemented in 2021, Congress put the code on pause until January 2024 as a way to cut costs during the pandemic.
In the 2024 Medicare Physician Fee Schedule, CMS has included full implementation of the G2211 code, but with appropriations battles looming over the coming months, the code could be in jeopardy. AAFP says family physicians need to contact their congressional representatives and senators through the Speak Out advocacy tool and tell Congress to support high-quality primary care.
In a letter sent to each member of the Texas congressional delegation, TAFP President Emily Briggs, MD, MPH, argued that existing billing codes in Medicare do not account for the work primary care physicians do to manage the care of patients with complex, multiple interdependent conditions.
“TAFP asks that you support the implementation of HCPCS [Healthcare Common Procedure Coding System] code G2211, and not take any action that would delay or halt implementation of the code on January 1, 2024,” Briggs wrote. “Instead, Congress should prioritize reforming Medicare budget neutrality to provide relief from these unnecessary annual payment reductions and enable Medicare to invest in all of the services beneficiaries need. This relief should not be provided at the expense of long overdue investments in primary care.”
Briggs wrote that the current Medicare physician payment system pits medical specialties against one another as payment rates become increasingly inadequate and physician practices struggle to stay afloat. “This ultimately prevents CMS from being able to implement evidence-based policy improvements that strengthen the Medicare program and advance access to high-quality care for beneficiaries. Our nation’s seniors deserve better.”
AAFP hosts a page of active Speak Out campaigns here: www.aafp.org/advocacy/fight/speak-out.mem.html. The top campaign is now titled “Congress Must Value Primary Care.” That is the one calling for full implementation of the G2211 billing code. In only a few moments, you can make your voice heard on this critical issue.