What is this “Continuity of Care” Fee on My Bill?

Medical offices that take insurance get paid by “coding” what they do. These codes are designated by the Center for Medicaid and Medicare Services (CMS). A new code – G2211 – has been created for primary care providers to indicate that they are following patients longitudinally and are committed to caring for the “whole patient” over time.

Unlike urgent cares and emergency rooms, Center City Pediatrics takes pride in offering this type of care and is excited that CMS is finally recognizing what we do. As such, we will be adding this “code” to all permitted visits, which now includes all patient encounters except for those designated as “Well Visits”.

Unfortunately, many insurance companies are not paying for all the services we provide, even if CMS says we need to document and “code” for it. Some carriers will completely deny payment. Others will pass the charge on to the patient. We are not happy with their position, and feel it is unfair both to us and to you. But, per our contracts with the insurance companies, we must continue to code for services as instructed. If you receive a bill for this code (typically less than $20), we will not be able to waive the charge. Instead, we ask that you follow up with your carrier directly for reimbursement.

We take great pride in providing your child with the highest quality of care possible. Documenting and coding appropriately for the services we provide is necessary for us to continue to serve our families in this way.