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G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time...
HCPCS Procedure & Supply Codes
G2212 - Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)
The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
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The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
Additional Code Information includes:
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HCPCS Index Entries (Reverse Index Lookup) 
reverse_index/reverse_index_content.php?set=HCPCS&c=G2212
View historical information about the code including when it was added, changed, deleted, etc. Access to this feature is available in the following products:
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Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. Access to this feature is available in the following products:
Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. |
Medicare Processing Note #0008
THIS PROCESSING NOTE DELETED 1/1/97.
Medicare - Carrier Priced
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
dmepos/dmepos_content.php?set=HCPCS&c=G2212
Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $30.96 | $46.44 | $61.91 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $30.96 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $32.29 | $48.43 | $64.58 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $32.29 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
This section shows APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Access to this feature is available in the following products:
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View fees for this code from 4 different built-in fee schedules and from those you've added using the Compare-A-Fee™ tool. If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Fee™ tool.
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View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. Access to this feature is available in the following products:
Note: Subscribers will see the fee graphs below. |
View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. Access to this feature is available in the following products:
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Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.61 | 0.27 | 0.05 | 0.930 |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.61 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.50 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| otoscope-ophthalmoscope (wall unit) | $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.270 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.61 | 0.31 | 0.05 | 0.970 |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.61 |
Clinical Labor (Non-Facility)- Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.50 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| otoscope-ophthalmoscope (wall unit) | $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.310 |
View relationships (or crosswalks) between code sets. Access to this feature is available in the following products:
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Medicare Policies & Guidelines (Articles, LCDs, NCDs)
coverage/coverage_content.php?set=HCPCS&c=G2212
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