Which private payers cover the new G2211 code?

Medicare began covering the new G2211 add-on code in January, but private payer coverage varies because each plan sets its own payment rules. To help practices navigate payment for the new code, the American Academy of Family Physicians (AAFP) has compiled a list of confirmed payers. See the AAFP's National G2211 Private Payer Coverage Matrix.

As of March 2024, the following national payers have confirmed coverage of G2211:

• Aetna (Medicare Advantage),
• Anthem (Medicare Advantage),
• Cigna (Medicare Advantage),
• Humana (commercial and Medicare Advantage), 
• UnitedHealthcare (Medicare Advantage). NOTE: UHC announced June 1, 2024, that it will no longer cover G2211 in its commercial plans and certain other lines of business effective Sept. 1, 2024.

Other payers or lines of business are not confirmed. For additional details, see the matrix, which the AAFP will update as it receives additional coverage information.

For more information about G2211, see the following:

• G2211: Simply Getting Paid for Complexity (FPM article about how to use the new code),
  
• AAFP G2211 Member Resources (including the payer matrix, coverage and denials guide, sample letters to payers and employers, and a template for tracking your own payers' coverage of the code).
  

— FPM Editors

Posted on March 4, 2024