G2212 Medicaid Rate by State

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)

22 state Medicaid programs publish a fee-for-service rate for G2212 (prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)), ranging from $17.17 in New Jersey to $43.55 in Montana, with a median of 80.2% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for G2212. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

22

Median % of Medicare

80.2%

Rate range

$17.17 - $43.55

G2212 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
California$26.2977.2%--2026
District of Columbia$30.0088.1%Not required2026
Hawaii$31.5792.7%--2025
Iowa$26.2577%--2024
Idaho$30.9490.8%Not required2026
Indiana$30.1388.4%--2025
Kansas$19.5357.3%--2024
Louisiana$29.1885.6%--2026
Maine$23.5269%--2026
Michigan$21.7363.8%--2026
Minnesota$25.9776.2%--2026
Montana$43.55127.8%--2026
North Dakota$37.17109.1%Not required2026
New Hampshire$33.7599.1%Not required2026
New Jersey$17.1750.4%Not required2026
New Mexico$31.4392.3%--2023
Ohio$23.6069.3%--2021
Oklahoma$30.3889.2%--2026
Oregon$27.33*80.2%--2026
Washington$20.2659.5%--2026
Wisconsin$24.9973.3%--2021
West Virginia$23.9170.2%--2026

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.

Related physician codes

All 17 codes from G2010 to G2252 or every physician code by number.

Frequently asked questions

How much does Medicaid pay for G2212?

22 state Medicaid programs publish a fee-for-service rate for G2212 (prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)), ranging from $17.17 in New Jersey to $43.55 in Montana, with a median of 80.2% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for G2212?

Montana publishes the highest Medicaid rate for G2212 at $43.55 (127.8% of the national Medicare amount). New Jersey publishes the lowest at $17.17.

Does G2212 require prior authorization under Medicaid?

No publishing state flags G2212 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.