Update: PPE CPT® Code 99072 and Medicare | News | APMA
Update: PPE CPT® Code 99072 and Medicare

November 3, 2020

The American Medical Association (AMA) published a new Current Procedural Terminology (CPT®) code on September 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency. CMS announced on October 27 it has assigned CPT 99072 procedure status “B.” 

The code is effective immediately: CPT 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.

Some third-party payers have and will reimburse providers for this new CPT code, others won’t. Status "B" means: 

  • there are no RVUs for this code; 
  • CMS considers it to be bundled with whatever service was provided that day;
  • CMS’ contractors will not pay for this service;
  • providers may not bill the beneficiary for this service; and 
  • issuing an Advanced Beneficiary Notice related to this service is not an option.

The CPT Editorial Panel creates CPT codes, but plays no role in developing payment for those codes. CPT is a registered trademark of the AMA.

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