New CPT Code Approved to Help with COVID-19 Burden

The American Medical Association and CPT Editorial Panel announced a new code for providers to report extra costs from supplies and services needed to deal with the COVID-19 pandemic. The new code, 99072, reads:

“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 supplies include cleaning materials such as wipes and hand sanitizer, as well as PPE. The additional clinical time includes staff services to provide pre-visit screenings, instructions for new distancing protocols during the visit, and extra time spent sanitizing rooms and equipment. 

The AMA states that providers can report 99072 for any non-facility, face-to-face encounter with a patient where an evaluation or other service is provided. Stipulations include that a government public health emergency must be in effect at the time of service, and providers can only report the code once per patient encounter. 

Major insurance carriers have not yet released fees or coverage guidelines for 99072. For the time being, it is likely they will treat it as an unlisted code, and process it based on ancillary fee provisions in their contracts. If covered, this means the allowed amounts may be calculated as a flat percentage of the charge. Insurance carriers may also frequently request notes on claims submitted with 99072. Providers who wish to bill this code should make a habit of adding corresponding notes to their medical records to justify the additional supplies and services.