Policy Update: Medicare Status B, P, and T Services Reimbursement

The payment policy “Medicare Indicator Status B and Status T Services Reimbursement” has been updated and revised to include additional services that will no longer be reimbursed, both effective with claim dates of service on and after October 6, 2024.

Status P procedure codes:

Status indicator P codes, as designated on the current Centers for Medicare and Medicaid Services (CMS) National Physician Fee Schedule, are incidental to services when provided on the same day as a physician or other qualified healthcare professional service. These codes will be bundled into the payment for the physician or other qualified healthcare professional service and may no longer be reimbursed.

Policy Exceptions:

• Procedure code V2520 is exempt from Status P policy criteria and will continue to be allowed reimbursement. Code V2520 – Contact lens, hydrophilic, spherical, per lens.
• DME agencies and DME suppliers who submit DME Status P supplies without any other physician service on the same claim are exempt from Status P policy criteria.

Status B procedure codes:

Procedure code G2211 will return to being a bundled service and no longer reimbursed.

G2211– Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition. (Add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)

To review the full payment policy updates effective with claim dates of service on and after October 6, 2024, review the policy (cmi_059327) in the Availity provider secure portal.