CPT Code 99072 was created by the CPT Panel in response to these extra practice expenses associated with patient care during the Public Health Emergency. CPT 99072 can be used to report the additional materials such as extra cleaning supplies, face masks, personal protective equipment, thermometers and clinical staff time, including but not limited to pre-visit instructions and office arrival symptom checks that support the safe provision of evaluation, treatment, or procedural service during this unprecedented time. This code can be used in conjunction with office visits and other non-facility service(s) when the office visit or other non-facility service(s) are rendered during the Public Health Emergency (PHE), as defined by law, if the practice itself incurs such expenses. Unless extended, the current PHE for COVID-19 is scheduled to expire on October 25, 2020.
When reporting CPT code 99072, practices should report the code only once per in-person patient encounter per day regardless of the number of services rendered at that encounter. Code 99072 may be reported during a PHE when the additional clinical staff duties as described are performed by the physician or other qualified health care professional in lieu of clinical staff.
Additional coding guidelines for 99072:
- The time counted in any other time-based visit or service during the same encounter cannot be counted twice to report this code.
- You do not need to link the code to a particular diagnosis code such as ICD-10-CM U07.1 COVID-19.
- You may report 99072 with an evaluation and management (E/M) service or procedure even if it is not PHE-related.
- You may report 99072 only once per in-person patient encounter per Provider Identification Number (PIN).
Coverage for this code is not yet established with most payers. Proposed payment to Medicare is around $6 but not yet allowed as the overall cost to Medicare would be significant and of course the cost is currently being absorbed unfairly by your practice.
