DecisionHealth, DecisionHealth - 2025 Issue 11 (November)

CMS expands complexity of care, refocuses SDOH on nutrition, exercise

Providers will have more opportunities to report G2211, the complexity of care add-on code next year. Effective Jan. 1, 2026, providers will be able to report the code with E/M encounters in more settings, CMS announced in the final 2026 Medicare physician fee schedule. In addition, the agency won’t cover the social determinants of health risk assessment but instead will assign a new descriptor to the code.

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