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Did you incur additional expenses in your efforts to provide safe in-person visits during the coronavirus pandemic? There's a CPT code for that.

Recently, the American Medical Association published an update to the Current Procedural Terminology (CPT®) code set that includes a code for reporting expenses incurred as a result of the necessary public health response to the COVID-19 pandemic. The code — 99072 — is a new practice expense code that describes the additional supplies and clinical staff time required to stop the spread of the coronavirus while still providing safe in-person visits.

According to coding guidance from AMA, the additional supplies, materials, and clinical staff time covered under the new CPT code include additional personal protective equipment, patient symptom checks over the phone and upon arrival, donning and removing PPE, and increased sanitation measures and supplies to prevent the spread of communicable disease.

The code should be reported only once per in-person patient encounter (office visit or other service), regardless of the number of services provided during the visit, the guidance says, but use of the code isn't dependent on a specific patient diagnosis.

The AMA/Specialty Society RVS Update Committee worked with 50 specialty societies, including APTA, over the summer to collect data on the costs of maintaining safe offices and time spent to educate therapists and their patients during the public health emergency.

Although 99072 describes "clinical staff time," AMA notes that the code also can be reported when qualified health care providers perform activities normally carried out by clinical staff, such as pre-visit screening or equipment and room cleaning.

The new code is available for immediate reporting on claims; however, CMS has not yet published an opinion on whether 99072 is covered under Medicare. Providers should verify with their state Medicaid programs and commercial insurers regarding eligibility for payment and coverage of the code.

For more information, contact advocacy@apta.org


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