G2212 HCPCS code: 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)
G2212 is the HCPCS Level II code for 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). In 2024 Medicare paid an average of $23.86 per service for G2212 across 959,448 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 6 per day on outpatient hospital claims. Medicare volume rose 62% from 2022 to 2024 (593,755 to 959,448 services). In 2024, about 63,171 clinicians billed Medicare for G2212 for 403,230 beneficiaries; California, Massachusetts, Minnesota accounted for 26% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | M5D |
| Added | 2021-01-01 |
| Last action effective | 2023-01-01 |
Who bills G2212 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 63,171 |
| Medicare beneficiaries | 403,230 |
| States with claims | 55 |
| Share of services in top 3 states (California, Massachusetts, Minnesota) | 26% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G2212, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 593,755 | 256,809 | $32.06 | $24.97 |
| 2023 | 741,084 | 305,625 | $30.83 | $24.10 |
| 2024 | 959,448 | 403,230 | $30.62 | $23.86 |
States with the most G2212 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 139,427 | $26.08 |
| Massachusetts | 54,150 | $24.81 |
| Minnesota | 52,414 | $22.86 |
| Florida | 50,022 | $24.10 |
| New York | 47,042 | $25.81 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 6 | Clinical: Data |
| practitioner claims | 6 | Clinical: Data |
What changed for G2212
- 2021-01-01: G2212 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G2212?
G2212 is the HCPCS Level II code for 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). Short descriptor: "Prolong outpt/office vis".
How much does Medicare pay for G2212?
In 2024, the average Medicare payment was $23.86 per service (average allowed $30.62).
Does Medicare cover G2212?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of G2212 can be billed per day?
6 on outpatient hospital claims; 6 on practitioner claims (NCCI medically unlikely edits).
Related G22 codes
- G2200 — Patient identified as an unhealthy alcohol user received brief counseling
- G2201 — Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)
- G2202 — Patient did not receive brief counseling if identified as an unhealthy alcohol user
- G2203 — Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)
- G2204 — Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period
- G2205 — Patients with pregnancy during adjuvant treatment course
- G2206 — Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2207 — Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky <=50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)
- G2208 — Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2209 — Patient refused to participate
- G2210 — Residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given
- G2211 — Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)
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Next steps
- Run a reimbursement report for a device billed under G2212
- Watch G2212 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G2212
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.