Covid-19 continues to bring about challenge and change in terms of requirements for your clinic to be open and the safety precautions required for patient care. To help ease the financial burden of meeting the mandated requirements and continuing to provide essential chiropractic and physical therapy care for your patients, the AMA has announced a new CPT code 99072.
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 infections disease.
Basically, 99072 is a new CPT code created and approved to help offset the additional staff & supply costs of Covid-19 as outlined in the code description. This includes things like the extra time your staff spends disinfecting surfaces and screening patients. It also includes the cost of safety supplies such as: disinfectants, gowns, gloves, disposable wipes/towels, masks, sanitizers, barriers used to separate spaces/contact, increased laundry costs, and increased janitorial/cleaning services, etc.
It is important to know that not all insurance companies are accepting this code. For example, Medicare and other government plans are not currently reimbursing for this code. It is also important to know that even if the insurance company is accepting the code, they may not actually pay it. Whether they require it to be taken as a provider reduction or process it as patient responsibility also seems to vary at this time.
Though it is a positive development, it does come with requirements to be valid:
- You are required to track & prove the increased costs that you are considering when choosing your fee for this code. You must keep all receipts and be able to show how you have calculated the increased staff time required.
- You will need to add up all related monthly expenses and divide this total by the number of patients you see on average each month to determine your cost per patient. This cost per patient number is what should be used as your fee for the 99072.
- As with any code you bill, the 99072 code is subject to audit. We recommend you don’t bill it if you are not going to do the first two items listed above.
Also keep in mind that this is a new code for everyone, including the insurance companies. To date we have not seen a lot of information overall on how this code processes, nor have we seen consistency in how it processes. In the limited billing of this code that we have done, we have seen up to $10 paid per visit. We have also seen it denied as a provider reduction and denied as a patient responsibility.
Money Tree Billing Clients: If you intend to start billing the 99072 code, please connect with your MTB contact person to let them know: (1) you intend to start using the code so that we can pay special attention to how or if it’s processing for your office, (2) what fee you intend to charge per visit, and (3) if you intend to charge your patients for this service if applicable after processing.
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