Ambetter Health Billing Code Update for HCPC Codes G2211 & G2212: Effective 04/01/2026

Date: 01/27/26

HCPC codes G2211 & G2212 will no longer be covered by Ambetter beginning on Apr. 1, 2026.

• HCPC Code G2211 is an add-on Medicare code used to bill for the complexity of an office or outpatient visit due to the longitudinal and ongoing nature of the practitioner-patient relationship, not the specific condition itself. 

• HCPC code G2212 is an add-on Medicare code used to report prolonged office or other outpatient evaluation and management (E/M) services beyond the maximum time of a primary E/M code. This code is submitted in 15-minute increments.

Providers should continue utilizing CPT E&M codes (i.e., 99202–99205, 99211–99215) as appropriate.

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative.