G2211, SDOH, and New Billing Opportunities

Description

Medicare physician final rule introduced multiple new billing opportunities for physician practices additional reimbursement for long term patients with chronic conditions (G2211). This add-on code provides additional payments to providers long term monitoring and developing an ongoing relationship with their complex patients. G2211 has not been without confusion on when and how to report. Another opportunity is for evaluating patients that may have social issues impacting their healthcare (G0136) as well as helping these patients overcome these issues through trained personnel, G0019 and G0022 Community health integration (CHI) services. Caregiver training (96202, 96203, 97550, 97551 and 97552) using a wide range of auxiliary personnel. Lastly Principle Illness navigation (PIN) (G0023, G0024, G0140 and G0146) a new billing opportunity for helping patients with diagnosed with high-risk conditions — e.g., cancer, mental health conditions, substance use disorder (SUD) etc identify and connect with appropriate practitioners and providers in a timely manner for care and support resources.

Webinar Objectives

Understand and implement the new Medicare billing opportunities in your practice setting.

Webinar Highlights

• Understand when G2211 can and cannot be reported.
• Documentation to support billing G2211
• Patient circumstances that may support billing SDOH (G0136)
• Required follow up when identifying patient specific SDOH issues.
• Appropriate care giver training providers
• Frequency of allowed care giver services
• Requirements for reporting “incident to” for caregiver trainer, CHI and PIN services
• Reduce denials and/or compliance risks

Who Should Attend

• Physicians and QHP Providers
• Coders
• Office managers
• Auditors
• Denial resolution teams
• Insurance payers