G2212 Prolonged office visit Medicare reimbursement rates in Virginia

G2212 captures prolonged physician or qualified health care professional work for a new or established level 5 office or outpatient E/M visit selected by total time. Time on the service date may include reviewing outside records, examining and counseling the patient, discussing treatment with other clinicians, and documenting the encounter, whether or not the patient is present. Physicians, nurse practitioners, and physician assistants may report it in primary care or specialty clinics and hospital outpatient departments when extensive record review and extended counseling make a visit unusually long.

Report G2212 with 99205 or 99215; Medicare uses it instead of CPT 99417 for these prolonged visits. Current CPT sets a minimum of 60 minutes for 99205 and 40 minutes for 99215. Under Medicare's prolonged-time thresholds, the first G2212 unit begins at 89 total minutes with 99205 or 69 with 99215; another unit begins after each further 15 minutes. Document total practitioner time on the date and the work performed. Exclude clinical staff time and time spent on separately reported services.