Medical Billing Terms H: HCPCS G2211, G-Codes and H-Code Terms

HCPCS G2211 is an add-on code for the extra work of ongoing, longitudinal care. This page defines it with the other HCPCS G-codes, the H-codes, HCPCS itself, HEDIS, HDHP and HFMA. Each entry gives a plain definition, why it matters, an example, and an official source. MCM South Medical Billing Service, LLC works only in mental and behavioral health billing.

Last reviewed: October 10, 2026Sources linked at each term

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Billing Terms Glossary slide, Terms H: HCPCS G2211 - MCM South Medical Billing Service, LLC

Glossary pages

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Pages in H

H-1H-2

On this page (18 terms)

H0031
H2015
H2017
HCPCS G0318
HCPCS G0396
HCPCS G0397
HCPCS G0442
HCPCS G0443
HCPCS G0444
HCPCS G2211
HCPCS G2212
HCPCS (Healthcare Common Procedure Coding System)
HCSC (Health Care Service Corporation)
HDHP (High-Deductible Health Plan)
Health First Colorado
HEDIS
HFMA (Healthcare Financial Management Association)
HHS (Department of Health and Human Services)

How to use these HCPCS G2211 definitions

Use this page as a quick reference for HCPCS G2211, from H0031 to HHS. Each entry gives a plain definition, why it matters to a mental health practice, and an official source. When a rule changes by payer or state, the entry says so, so confirm HCPCS G2211 details with the payer before you bill.

Checklist: put the hcpcs g2211 definitions to work

Check the hcpcs g2211 entries above before you send a claim that depends on them.
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H0031

General (all payers)

Also called H0031 code

Definition: A HCPCS code for a mental health assessment by a non-physician, used by some state Medicaid programs and payers.
Why it matters: Unverified for in-home use; state and payer policy decides coverage.
Illustrative example: A state lists H0031 for a mental health assessment.

Related termsMedicaid HCPCS Code H2015

Reference sourceCMS HCPCSchecked 10/9/26

CategoriesMedicare & Medicaid Terms Behavioral Health Specific Terms

H2015

General (all payers)

Also called H2015 code

Definition: A HCPCS code for comprehensive community support services, per 15 minutes, used by some state programs.
Why it matters: Unverified for in-home use; state policy decides coverage.
Illustrative example: A state lists H2015 with 15-minute units.

Related termsMedicaid HCPCS Code H2017

Reference sourceCMS HCPCSchecked 10/9/26

CategoriesMedicare & Medicaid Terms Behavioral Health Specific Terms

H2017

General (all payers)

Also called H2017 code

Definition: A HCPCS code for psychosocial rehabilitation services, per 15 minutes, used by some state programs.
Why it matters: Unverified for in-home use; state policy decides coverage.
Illustrative example: A state lists H2017 with 15-minute units.

Related termsMedicaid HCPCS Code H2015

Reference sourceCMS HCPCSchecked 10/9/26

CategoriesMedicare & Medicaid Terms Behavioral Health Specific Terms

HCPCS G0318

Medicare

Also called G0318; Medicare prolonged home or residence visit

Definition: HCPCS G0318 is Medicare's prolonged home or residence E/M add-on. It is reported with 99345 or 99350 when time reaches Medicare's own threshold.
Why it matters: One published summary states the thresholds as at least 140 minutes with 99345 and at least 110 minutes with 99350, counting work from three days before to seven days after the visit. Confirm the current CMS rule before you rely on those figures.
Illustrative example: A Medicare home visit with a high-complexity established patient runs long, and the practice bills 99350 plus G0318 if the threshold is met.

Reference sourceSTFM Practice Management Handbook, Home or Residence Visits CMS (Centers for Medicare & Medicaid Services)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

HCPCS G0396

Medicare

Also called G0396; alcohol or substance structured screening and brief intervention 15 to 30 minutes

Definition: HCPCS G0396 is structured alcohol and/or substance (other than tobacco) misuse screening and brief intervention of 15 to 30 minutes. It is the Medicare G-code counterpart to CPT 99408.
Why it matters: Confirm whether the payer wants the G-code or the CPT code. Document the screening tool, the feedback given, and the time.
Illustrative example: A clinic bills G0396 to Medicare for a 20-minute structured screening and brief intervention.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

HCPCS G0397

Medicare

Also called G0397; alcohol or substance structured screening and brief intervention 30 minutes or more

Definition: HCPCS G0397 is structured alcohol and/or substance (other than tobacco) misuse screening and brief intervention of more than 30 minutes. It is the Medicare G-code counterpart to CPT 99409.
Why it matters: Use it only when the documented time exceeds the G0396 range. Confirm which code the payer requires.
Illustrative example: A 40-minute structured brief intervention for a Medicare patient is billed G0397.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

HCPCS G0442

Medicare

Also called G0442; annual alcohol misuse screening

Definition: HCPCS G0442 is the annual alcohol misuse screening code, reported for a 15-minute screening.
Why it matters: Pair it with G0443 when brief face-to-face counseling follows. Confirm frequency limits and whether a payer wants the G-code or a CPT equivalent.
Illustrative example: A clinic screens a Medicare patient for alcohol misuse and bills G0442.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

HCPCS G0443

Medicare

Also called G0443; brief face-to-face alcohol misuse counseling

Definition: HCPCS G0443 is brief face-to-face behavioral counseling for alcohol misuse, reported for 15 minutes.
Why it matters: It follows a positive screen. Document the counseling content and time. Confirm the payer's frequency limits.
Illustrative example: After a positive screen, a clinician spends 15 minutes on brief counseling and bills G0443.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

HCPCS G0444

Medicare

Also called G0444; annual depression screening; Medicare depression screening

Definition: HCPCS G0444 is Medicare's annual depression screening code, reported for a 15-minute screening.
Why it matters: G-codes are HCPCS Level II codes used mainly for Medicare and Medicaid. Confirm current CMS and payer frequency limits, since depression screening is typically covered once a year, and confirm whether the payer wants the G-code or a CPT screening code such as 96127.
Illustrative example: A primary care office screens a Medicare patient once in the year and bills G0444.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Behavioral Health Specific Terms

HCPCS G2211

Medicare

Also called G2211; visit complexity add-on; Medicare E/M add-on

Definition: HCPCS G2211 is a Medicare add-on code for the visit complexity inherent to an E/M visit that is the continuing focal point for a patient's health care or part of ongoing care for a single serious or complex condition.
Why it matters: CMS limits when it pays, including limits when the E/M is billed with modifier 25. Read the current CMS FAQ before you bill it. Many commercial payers do not recognize it.
Illustrative example: A psychiatrist who provides ongoing care for a patient's serious mental illness bills G2211 with the office E/M where Medicare allows it.

Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

HCPCS G2212

Medicare

Also called G2212; Medicare prolonged office E/M

Definition: HCPCS G2212 is Medicare's prolonged office or outpatient E/M add-on, used instead of CPT +99417 when the visit runs past Medicare's own time threshold.
Why it matters: Medicare's thresholds differ from CPT's. Confirm the current CMS time threshold and documentation rules.
Illustrative example: A Medicare patient's visit runs past the CMS threshold, so the practice reports G2212 with a level 5 E/M.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS Medicare Learning Network (MLN)checked 10/9/26

CategoriesCPT, E/M & HCPCS Code Entries Claims Processing

HCPCS (Healthcare Common Procedure Coding System)

General (all payers)

Also called HCPCS; HCPCS Level II; HCPCS codes

Definition: A code set with two levels: Level I is CPT, and Level II covers supplies, services, and items not in CPT, including many Medicaid behavioral health services.
Why it matters: State Medicaid programs commonly use HCPCS Level II codes for community-based behavioral health services.
Illustrative example: A state Medicaid manual lists an H-code for psychosocial rehabilitation.

Reference sourceCMS (Centers for Medicare & Medicaid Services)CMS HCPCSchecked 10/9/26

CategoriesClaims Processing Medicare & Medicaid Terms

HCSC (Health Care Service Corporation)

Private payer

Also called HCSC; Blue Cross and Blue Shield of Texas; BCBSTX

Definition: A Blue licensee company that operates Blue plans in several states, including Blue Cross and Blue Shield of Texas.
Why it matters: BCBS-TX is HCSC; its rules should not be assumed to apply to other licensees.
Illustrative example: A Texas therapist follows BCBS-TX provider manuals.

Reference sourceHCSCchecked 10/9/26

CategoriesBCBS, UHC & Commercial Payer Terms

HDHP (High-Deductible Health Plan)

General (all payers)

Also called HDHP; high deductible plan

Definition: A health plan with a higher minimum deductible than traditional plans, often paired with an HSA.
Why it matters: Patients often pay more out of pocket early in the plan year, affecting collections.
Illustrative example: A patient with an HDHP pays the full allowed amount until the deductible is met.

Reference sourceHHS (U.S. Department of Health and Human Services)checked 10/9/26

CategoriesPatient Financial Responsibility Terms Eligibility & Benefits

Health First Colorado

Medicaid (state-specific)

Also called Colorado Medicaid

Definition: The name of Colorado's Medicaid program.
Why it matters: Colorado is a served state; Medicaid rules there are separate from other states.
Illustrative example: A Colorado provider enrolls with Health First Colorado.

Reference sourceMedicaid.govchecked 10/9/26

CategoriesMedicare & Medicaid Terms

HEDIS

General (all payers)

Also called Healthcare Effectiveness Data and Information Set

Definition: A set of performance measures maintained by NCQA that health plans use to report quality, including behavioral health measures such as follow-up after hospitalization.
Why it matters: Payers may ask practices for records or outreach to close HEDIS gaps.
Illustrative example: A plan requests follow-up visit records for HEDIS reporting.

Related termsNCQA Care Gap Star Ratings

Reference sourceNCQAchecked 10/9/26

CategoriesQuality & Risk Adjustment Terms Value-Based Care Terminology

HFMA (Healthcare Financial Management Association)

General (all payers)

Also called HFMA

Definition: A professional association for healthcare finance leaders that publishes revenue cycle guidance and metric definitions.
Why it matters: Common reference for revenue cycle metrics such as days in A/R.
Illustrative example: A manager uses HFMA definitions for KPI reports.

Reference sourceHFMAchecked 10/9/26

CategoriesRevenue Cycle Metrics

HHS (Department of Health and Human Services)

Private payer

Also called HHS

Definition: The federal department that oversees CMS, OIG, OCR, HRSA, SAMHSA, and other health agencies.
Why it matters: Parent agency for many rules referenced in billing.
Illustrative example: A rule is issued by HHS.

Reference sourceHHS (U.S. Department of Health and Human Services)checked 10/9/26

CategoriesMedicare & Medicaid Terms Audits & Compliance

Quick answer: HCPCS G2211

What is HCPCS G2211?

HCPCS G2211 is a Medicare add-on code for the visit complexity inherent to an E/M visit that is the continuing focal point for a patient's health care or part of ongoing care for a single serious or complex condition. CMS limits when it pays, including limits when the E/M is billed with modifier 25.

Frequently asked questions: HCPCS G2211

What is HCPCS?

HCPCS (Healthcare Common Procedure Coding System) is a code set with two levels: Level I is CPT, and Level II covers supplies, services, and items not in CPT, including many Medicaid behavioral health services. State Medicaid programs commonly use HCPCS Level II codes for community-based behavioral health services.

What is HEDIS?

HEDIS is a set of performance measures maintained by NCQA that health plans use to report quality, including behavioral health measures such as follow-up after hospitalization. Payers may ask practices for records or outreach to close HEDIS gaps.

What is an HDHP?

HDHP (High-Deductible Health Plan) is a health plan with a higher minimum deductible than traditional plans, often paired with an HSA. Patients often pay more out of pocket early in the plan year, affecting collections.

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