G2212
Prolonged office o/p E/M ea 15 min (Medicare)
Prolonged office or other outpatient evaluation and management service, each additional 15 minutes, Medicare's replacement for 99417. CMS 2026 wRVU 0.61, paid using the national GPCI and the 2026 conversion factor of $33.4009. Add-on only, attaches exclusively to 99205 and 99215, and only for Medicare and Medicare Advantage patients.
Billing guidance for G2212 is locked
- When to use it: the exact clinical situations that support billing G2212
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get G2212 downcoded or denied
Payer notes
Medicare and Medicare Advantage pay G2212 at roughly the same rate as one mid-level established visit, so capture matters on long encounters: a 90-minute new-patient visit billed as 99205 alone leaves the prolonged work uncompensated. Commercial payers generally do not recognize G2212 and expect 99417. For dual-eligible or secondary-payer situations, bill per the primary payer's rule. G0316, G0317, and G0318 are the parallel Medicare prolonged codes for inpatient/observation, nursing facility, and home settings; G2212 is strictly office and outpatient.