MedicaidCoverageMedium impact
KMAP BULLETIN: Billing Guidelines and Required Documentation for Visit Complexity Add-on Code G2211
Kansas Medicaid (KanCare)·KS·Coding
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Summary
Starting April 1, 2025, Kansas Medicaid will cover the visit complexity add-on code G2211 when billed with office/outpatient E/M visits for providers who serve as the continuing focal point of care or manage serious/complex conditions. Documentation must support medical necessity and the reason for billing the E/M visit.
Action Required
Before April 1, 2025: Billing team must update system to allow G2211 add-on billing with E/M codes 99202-99205 and 99211-99215 for Kansas Medicaid patients when provider is continuing focal point of care or managing serious/complex conditions. Providers must document medical necessity, reason for E/M visit, assessment and plan in medical records. Cannot bill G2211 with modifier 25 or without associated E/M visit. Update encounter forms to remind providers of documentation requirements.