SUN-858 - Real-World Utilization Patterns of G2211 in Outpatient Endocrinology Practice

G2211 was introduced to capture longitudinal complexity and care coordination in outpatient evaluation and management (E/M) services. However, real-world utilization patterns across endocrinology practices remain incompletely described.

Objective
To characterize real-world prescribing patterns and variability of G2211 utilization in outpatient endocrinology practice.

Methods
We analyzed outpatient billing data from 28 endocrinologists practicing across a large, statewide health system that included academic and private-employed community settings. G2211 utilization was assessed over two representative clinic weeks per clinician. Frequency of G2211 use was summarized at the physician level and stratified by visit type (new vs established). Descriptive statistics were used to characterize overall utilization, inter-physician variability, and associations with visit volume and coding mix.

Results
Twenty-eight endocrinologists practicing across academic and private-employed community settings were included. G2211 utilization demonstrated substantial inter-physician variability over the two-week observation period. Several clinicians did not bill G2211 during the study period, whereas others frequently used the code.
Missed opportunities for G2211 billing were common and highly variable. The distribution of missed G2211 opportunities was non-normal (Shapiro–Wilk p< 0.001), with a median of 7.5 [1.0–49.0] missed encounters per physician over two weeks (range 0–103). While the mean number of missed opportunities was 24.0 ± 31.8, this reflected a right-skewed distribution driven by a subset of clinicians with high missed opportunity counts.
G2211 use occurred predominantly in established patient encounters and was infrequent with new patient visits. In unadjusted analyses, physicians with higher per-session productivity demonstrated higher overall G2211 utilization; however, after accounting for visit volume and E/M code mix, G2211 did not independently explain additional variability in per-session productivity.

Conclusion
In real-world outpatient endocrinology practice, G2211 utilization is variable and disproportionately applied to established patient visits, with infrequent use in new patient encounters. Marked inter-physician variability suggests differences in adoption and coding behavior rather than patient complexity alone, highlighting opportunities for education and standardization in complexity capture.

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