About 27% of Medicare office visits included the G2211 add-on code by mid-2025, according to an April 2026 Annals of Internal Medicine study of more than 377 million outpatient visits. A JAMA research letter on 2024 Medicare claims found that 24.0% of the 855,265 clinicians who billed an eligible visit billed G2211 at all.
The two numbers use different bases, so they do not conflict. One counts visits, the other counts clinicians. CMS also proposed on July 14, 2026 to turn G2211 into a modifier that raises the E/M payment by 16%, which changes what each billed visit is worth in 2027.
What the 2026 Annals study found
The study used Epic Cosmos data on outpatient visits from January 2024 to September 2025. It was published April 6, 2026 by the American College of Physicians, with Nate C. Apathy, PhD, of the University of Maryland as corresponding author.
In Medicare, G2211 appeared on about 5% of routine E/M visits in early 2024. The rate climbed to about 27% by mid-2025 and then held there. Commercial insurers paid for the code on no more than 12% of visits at any point, per HealthDay's April 8, 2026 summary of the study.
Early projections had expected more than one-third of qualifying encounters to carry the code, so actual use landed below the forecast. Endocrinology and internal medicine billed it most often. Dermatology billed it least. The ACP release gives no percentages by specialty.
Who bills it: 2024 Medicare claims by clinician type
The JAMA letter, published online February 19, 2026 by Ishani Ganguli and colleagues, covered 100% of traditional Medicare claims for 2022 to 2024. Among clinicians who billed at least one eligible visit in 2024, those who used G2211 billed it on a median of 30.1% of their eligible visits. The interquartile range ran from 6.9% to 61.8%, so some clinicians billed it on almost no visits and others on most.
| Clinician type | Share of all G2211 codes | G2211 billed per eligible visit | G2211 visits billed | First G2211 visit with no other visit with the patient |
|---|---|---|---|---|
| Primary care physicians | 39.7% | 24.1% | 9,616,505 | 8.2% |
| Specialist physicians | 43.0% | 13.1% | 10,789,868 | 9.0% |
| Other clinicians (NPs, PAs) | 17.4% | 8.9% | 4,206,416 | 30.1% |
Source: Ganguli et al., JAMA 2026;335(11), traditional Medicare claims, 2024. Overall, 15.2% of first G2211 visits had no earlier or later visit with the same patient.
Primary care physicians billed G2211 on 24.1% of eligible visits, nearly twice the 13.1% rate for specialists. Specialists still held the largest share of total codes because they log more eligible visits. Nephrology, rheumatology, geriatrics, endocrinology and urology had the highest per-visit rates.
What the code paid in 2024
The JAMA authors counted $394 million in total G2211 payments in 2024. The add-on paid about $16 per eligible visit. For the clinicians who billed it, G2211 made up 1.1% of total Medicare billing.
A small amount per visit adds up at volume. Take a practice with 1,000 eligible Medicare visits a month. At the median billing rate of 30.1% and $16 per code, G2211 brings in about $4,816 a month. At the 24.1% primary care rate it brings in about $3,856. At the 8.9% rate for other clinicians it brings in about $1,424. These figures are arithmetic on the JAMA averages, not a claim about any one practice.
The 2027 proposal: a 16% modifier
CMS released the CY 2027 physician fee schedule proposed rule on July 14, 2026. It would convert G2211 from a flat add-on code into a modifier. The modifier would raise the payment for the attached E/M visit by 16%. A second modifier for clinicians in arrangements such as the Medicare Shared Savings Program or the LEAD model would raise it by 32%, per the CMS fact sheet.
Comments closed September 14, 2026. The AMA expects a final rule by November 1, with most changes starting January 1, 2027. The same proposal sets the 2027 conversion factor at $33.17 for qualifying APM participants (down 1.19%) and $32.84 for everyone else (down 1.68%), because the one-year 2.5% increase for 2026 expires.
Robert Resnik, M.D., MBA, wrote in Medical Economics on August 7, 2026 that a 99214 pays about $135 in his locality. His estimates for that visit follow.
| Scenario | Estimated 99214 payment |
|---|---|
| 99214 alone, current rate | About $135 |
| 99214 plus G2211, current rate | About $150 to $152 |
| 99214 with 16% modifier, non-APM | About $150 to $160 |
| 99214 with 32% modifier, APM participant | About $175 to $180 |
Source: Medical Economics, Resnik, August 7, 2026. Dollar amounts vary by locality and by the final conversion factor.
On those estimates, the 16% modifier lands close to what a practice collects today for 99214 plus G2211. The 32% rate adds roughly $25 to $30 per visit over that. Resnik writes that about half of primary care physicians are qualified APM participants, and that more than 60% of physicians report at least some APM revenue.
Checks to run on your own claims
Pull 12 months of Medicare E/M claims and count the eligible visits. Divide the G2211 count by that total. A rate near 24.1% matches the primary care average in the JAMA data. A rate near 13.1% matches the specialist average. A rate under 8.9% sits below the group with the lowest rate.
Check the other direction too. In the JAMA data, 30.1% of first G2211 visits billed by NPs and PAs had no observed earlier or later visit with the same patient, against 8.2% for primary care physicians. A high share of one-time patients on G2211 claims is a documentation question to review before the code becomes a percentage of every visit.
For 2027 planning, run each E/M level through the 16% and 32% cases. If 99214 is your most common level, the table above gives the per-visit range to use until CMS publishes the final rule.
Sources
- JAMA, Billing of Medicare's G2211 Longitudinal Care Code Among Traditional Medicare Beneficiaries, February 19, 2026
- American College of Physicians via Newswise, Uptake of new Medicare G2211 code slower than projected by CMS, April 6, 2026
- HealthDay, Use of Evaluation, Management Add-On Code G2211 Remains Below Projected Adoption Levels, April 8, 2026
- CMS, Calendar Year 2027 Medicare Physician Fee Schedule Proposed Rule fact sheet, July 14, 2026
- Medical Economics, Medicare's 2027 Physician Fee Schedule: Will primary care finally be paid for what it actually does?, August 7, 2026
- AMA, 2027 proposed Medicare fee schedule: What physicians need to know, September 4, 2026
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