The ACR recently led a multispecialty sign-on letter to UnitedHealthcare urging the payer to reconsider its decision to discontinue reimbursement for G2211 for commercial plans as of Sept. 1.
UnitedHealthcare began reimbursing for the G2211 complex care add-on code on Jan. 1 for both commercial and Medicare Advantage plans. At the time, the ACR applauded the payer’s leadership among commercial plans for recognizing and investing in high-quality, patient-centered care. However, in July, UHC reversed its position and announced it would discontinue reimbursement for commercial plans as of Sept. 1, asserting that services associated with G2211 are considered bundled into the evaluation and management (E/M) visit.
In a letter to UHC dated Aug. 1, the ACR and seven other national medical societies assert that the Centers for Medicare & Medicaid Services has been very clear that services associated with G2211 are in addition to the outpatient E/M visit, not bundled into the level of the visit, and should be reimbursed accordingly. The groups urge UHC to reconsider its decision and continue reimbursement for commercial plans to help ensure clinicians are appropriately recognized for the additional work involved with managing complex and chronic diseases.
The other organizations joining the letter to UHC are the American Academy of Neurology, American Association of Nurse Practitioners, American Academy of Physician Associates, American College of Physicians, American Gastroenterological Association, American Society of Addiction Medicine and the Coalition of State Rheumatology Organizations.
If you have questions regarding G2211 or other insurance-related concerns, contact [email protected].
