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New CPT Code Approved for Reporting Additional Costs Due to COVID-19

Oct 05, 2020

Effective Sept. 8, 2020, the American Medical Association (AMA) added Current Procedural Terminology (CPT®) code 99072, Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease. The language and associated recommended reimbursement for this service was developed with input from 50 national medical specialty societies including AAPM&R. 

Academy members treating patients during the COVID-19 public health emergency have made many adjustments to their practices to create a safe environment for patients, staff and physicians.  These adjustments have significantly increased practice costs for staff time, cleaning supplies and personal protective equipment. 

As indicated in the code descriptor, code 99072 is limited to office visits and other non-facility services.  The code is intended to reimburse additional expenses including, but are not limited to, additional supplies, such as face masks and cleaning supplies, as well as clinical staff time for activities such as pre-visit instructions and office arrival symptom checks that support the safe provision of evaluation, treatment or procedural services during the respiratory infection-focused PHE.

As indicated by CPT, code 99072 should only be reported once per in-person patient encounter per day, per provider identification number, regardless of the number of services rendered at that encounter.

At this time, we are not aware of formal announcement of payment for 99072 by CMS or private payors.  However, we have heard anecdotally that some members are receiving payment for this code when billed with office visits or other non-facility services.