In January of 2024, Medicare introduced the G2211 add-on billing code to better recognize and reimburse the ongoing, longitudinal care provided by clinicians, particularly primary care physicians caring for the full range of their patients’ needs and specialists managing complex or serious conditions.

The policy aimed to strengthen support for continuous patient care, but questions remained about how the code would be used in practice and whether it would meaningfully benefit primary care.

Ishani Ganguli, MD, MPH

A study led by Ishani Ganguli, MD, MPH, of the Division of General Internal Medicine and Primary Care at Mass General Brigham, looked at early adoption of the G2211 code during its first year of implementation.

The researchers sought to understand how widely the code was used, which clinicians were billing it, and whether billing patterns aligned with Medicare’s stated goals.

Using 100% Medicare claims and administrative data, the research team analyzed all G2211-eligible evaluation and management visits among traditional Medicare beneficiaries in 2024—assessing billing patterns by patient, clinician, specialty and visit characteristics.

They also examined the most common primary diagnoses associated with G2211-billed visits and whether clinicians had ongoing relationships with the patients for whom they billed the code.

The study found rapid and substantial uptake of G2211 in its first year, with approximately 26 million codes billed for more than 10 million patients, totaling nearly $400 million in payments. While primary care physicians billed G2211 at the highest rate per eligible visit, the largest share of total G2211 payments went to specialists.

Use of the code varied widely across specialties, and in many cases, specialists billed G2211 for conditions that may not clearly meet Medicare’s definition of serious or complex illness. Most clinicians who billed G2211 had ongoing patient relationships, though a notable minority of initial G2211 claims occurred without evidence of prior or subsequent visits.

Overall, the findings suggest that while G2211 achieved stronger early adoption than previous care management codes, its specialty-agnostic design made it difficult to direct payments specifically toward primary care. The results highlight the challenges of using fee schedule adjustments alone to support longitudinal care, and suggest that alternative payment approaches may be needed to more effectively target clinicians responsible for comprehensive, ongoing patient care.

Published in JAMA on February 19, 2026| Read the paper: “Billing of Medicare’s G2211 Longitudinal Care Code Among Traditional Medicare Beneficiaries”

Summary reviewed by: Ishani Ganguli, MD, MPH, first author