Wiki Billing G2212 in 2024

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Cheezum51

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I've heard that the time ranges for the 99202-99215 codes are being removed from those codes in 2024. I've also been told that Medicare is still going to allow providers to bill the G2212 code for prolonged services when coded with the 992x5 E/M codes when those are selected based on time. Currently, the G2212 units are calculated based upon exceeding the current maximum time range for those two codes by at least 15 minutes.

Does anyone know how the G2212 will be calculated in 2024? If Medicare is going to stick by the current time guidelines, I would guess that they will allow the G2212 once you exceed the minimum time by 30 minutes? Can anyone confirm?

Tom Cheezum, OD, CPC, COPC
 
jkyles said:
Hi there, continue to follow the time guidelines that CMS published in CMS 100-04, Chapter 12, ss 30.6.15.2. The chart sets a minimum of 89 minutes for one unit of G2212 for 99205 and 69 minutes for 99215. CMS disagrees with the AMA/CPT definition for the 9941x codes, which is why it maintains a separate code set.

https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf
Click to expand...
It looks like NGS just made an update on 2/26/24 that looks like it matches CPT time guidelines. Since the time ranges were removed it now looks like it’s just 15 minutes past the base time.
 
I did see that recently. But until CMS makes the update, that only applies to providers in NGS' jurisdiction.

I would also highly recommend that everyone who bills G2212 to NGS save a copy of that page on their computer, just in case. 😁
 
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