Currentblue cross blue shield - tennesseePolicy N/A

Office and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code G2211

Describes BCBS Tennessee's implementation of CMS's change to make G2211 separately payable for select Tennessee products and guidance to follow CMS billing rules; affects providers billing BlueAdvantage (PPO) SM and BlueCare Plus (HMO D-SNP) SM plans.

Policy Summary

Payerblue cross blue shield - tennessee

PolicyOffice and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code G2211

Policy CodePolicy N/A

Change TypeCode status update — G2211 made separately payable for select plans

Effective DateJan. 1, 2024

Next Review DateN/A

Key ActionFollow CMS guidance on when and how to bill G2211 for the plans implementing separate payment.

SourceLink

POLICY UPDATE CHANGES

G2211 was made separately payable by assigning it an active status indicator effective Jan. 1, 2024.

Jan. 1, 2024effective date for G2211 active status

2plans implementing change

Commercial & BlueCare TNnetworks not implementing change

Coverage Criteria for G2211

Plans implementing separate payment

Separate payment for G2211 will be followed for specific BCBS TN plans in accordance with CMS guidelines.

ALL of the following

Applies to plan
- BlueAdvantage (PPO) SM
- BlueCare Plus (HMO D-SNP) SM
Follow CMS guidance on when and how to bill G2211; effective Jan. 1, 2024.

G2211 — Office and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code will be treated as separately payable for the above plans per CMS (active status indicator effective Jan. 1, 2024).

Policy Summary

Payerblue cross blue shield - tennessee

PolicyOffice and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code G2211

Policy CodePolicy N/A

Change TypeCode status update — G2211 made separately payable for select plans

Effective DateJan. 1, 2024

Next Review DateN/A

Key ActionFollow CMS guidance on when and how to bill G2211 for the plans implementing separate payment.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Plans not implementing change

Plans not adopting the CMS change for separate payment of G2211.

Commercial

BlueCare Tennessee

These networks will not implement the separate payment change; do not treat G2211 as separately payable for these products.

Coding and Effective Date

Add-on codeCPTCovered

G2211

Office and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code

inv-04: Effective date — 2024-01-01

Effective dateJan. 1, 2024

Implementation noteG2211 assigned an active status indicator and made separately payable effective Jan. 1, 2024.

Applies toBlueAdvantage (PPO) SM and BlueCare Plus (HMO D-SNP) SM plans only; follows CMS guidelines.

Not implemented forCommercial and BlueCare Tennessee networks will not implement the separate payment change.

Billing Guidance and Provider Actions

Billing Rule

Billing guidance — follow CMS rules; separate payment only for specified BCBS TN plans

Follow CMS guidance on when and how to bill G2211. BCBS TN implemented separate payment for G2211 for BlueAdvantage (PPO) SM and BlueCare Plus (HMO D‑SNP) SM plans only; Commercial and BlueCare Tennessee networks will not implement this change.

G2211 assigned an “active” status indicator and made separately payable effective Jan. 1, 2024; follow CMS billing guidance for correct use.
Separate payment implemented only for BlueAdvantage (PPO) SM and BlueCare Plus (HMO D‑SNP) SM; do not bill expecting separate payment for Commercial or BlueCare Tennessee networks.

Definitions

inv-06: G2211 — Office and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code

CodeG2211

DescriptionOffice and Outpatient Evaluation and Management Visit Complexity Add-on Payment Code

CMS changeCMS assigned an active status indicator making G2211 separately payable effective Jan. 1, 2024.

Billing guidanceFollow CMS guidance on when and how to bill this code correctly; BCBS TN will follow CMS guidelines for implementing separate payment for specified plans.