G2211, the office-visit complexity add-on for longitudinal care, stops being a separate line in 2027. CMS is converting it into a modifier, B1, appended to the E/M code. Instead of a flat add-on amount, B1 increases payment for that E/M by 16%.

A second modifier, B2, is available only to practitioners in a Medicare Shared Savings Program ACO or participant providers in a LEAD Model ACO. It increases the E/M payment by 32%, is voluntary, and can be billed for all beneficiaries the participant sees, not only those assigned to the ACO.

What actually changes in the claim

Today: E/M on one line, G2211 on a second line with its own allowed amount.
From January 1: E/M with modifier B1 (or B2) on a single line.

That sounds small. It touches every charge rule that auto-adds G2211, every EHR template that suggests it, every scrubber edit written around it, and every report that counts G2211 units.

The part most practices will miss

A flat add-on paid the same on a 99213 as on a 99215. A percentage does not. Under B1 the add-on is worth more on higher-level visits and less on lower ones, so under-coded visits lose twice: once on the E/M and again on the add-on. Practices with a level mix skewed toward 99213 should look at documentation and leveling before January, not after.

Run this before January 1

1. List every place G2211 is hard-coded: charge capture rules, EHR order sets and templates, clearinghouse edits, fee schedules, dashboards.
2. Pull 12 months of G2211 volume by provider and E/M level, and re-price it at 16% of the 2027 E/M allowed amount. Know whether you gain or lose before the first remit tells you.
3. If you are in an ACO, confirm whether participants will bill B2. Claims with B2 count in assignment and benchmark calculations.
4. Ask your top five commercial and Medicare Advantage payers in writing whether they will accept B1, keep G2211, or pay neither. Do not switch every payer on Medicare’s timetable.

Want a second pair of eyes on the re-pricing? Tell us.

What we do not know yet

The CMS fact sheet does not spell out how B1 interacts with a same-day modifier 25 visit, with the new rule that pays the lower-valued service at 80% when an office E/M and a 0-day global procedure share a date, or the claim-level edits MACs will apply. Read the final rule text and your MAC’s guidance before building edits on assumptions.

Source: CMS, Calendar Year 2027 Medicare Physician Fee Schedule Final Rule fact sheet, November 4, 2026 (cms.gov).