APTQI Signs Letter to House & Senate Leaders with G Code Coalition
On October 4, a letter was sent to Congressional leaders on behalf of 47 organizations, including APTQI, representing over 1.2 million physician and nonphysician providers and the patients they serve, urging Congress to halt the implementation of Healthcare Common Procedure Coding Systems add-on code G2211.
This code is set to be implemented in the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) proposed rule, set by the Centers for Medicare & Medicaid Services (CMS) and would result in Medicare payment cuts, harming medical practices and delaying patients’ access to care.
In 2021, significant changes were made to healthcare coding and payment policies in the MPFS. These changes included an overhaul of outpatient evaluation and management (E/M) codes and the introduction of the G2211 add-on code for primary care services.
G2211 faced opposition for being duplicative, leading to an estimated $11 billion increase in spending, causing a reduction in the CY 2021 conversion factor (CF). While primary care benefited from this change, other specialties faced payment cuts. Because these cuts were unsustainable, the G2211 code was postponed until 2024.
However, the three-year Congressional moratorium on G2211 is set to expire at the end of the year. CMS is proposing the implementation of the rule in the CY 2024 MPFS proposed rule.
APTQI opposes implementation of G2211 and is urging Congress to permanently halt its use under the MPFS. G2211 remains duplicative, would result in overpayments, and would penalize physicians who cannot or do not use the code. Implementing this code would hurt Medicare beneficiaries and reduce their access to care in their communities.
To read the House letter, CLICK HERE.
To read the Senate letter, CLICK HERE.