September 15, 2020
On September 8, 2020, the American Medical Association (AMA) released new Current Procedural Terminology (CPT®) code 99072 for reporting the cost of additional personal protective equipment (PPE), cleaning supplies, and clinician or clinical staff time needed to safely provide in-person services during the public health emergency (PHE).
The AMA worked with 50 specialty societies, including the American Speech-Language-Hearing Association (ASHA), to develop the new code. During this effort, over 4,600 audiologists and speech-language pathologists (SLPs) responded to an ASHA and AMA survey about the supplies and time required to maintain the safety of clinicians, patients, and clinical staff during the COVID-19 pandemic. The data collected helped inform AMA recommendations to the Centers for Medicare & Medicaid Services (CMS) regarding coverage and payment for the new code.
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
99072 captures the cost of supplies and activities required to mitigate the spread of COVID-19, including:
Although 99072 describes “clinical staff time”, the AMA notes that the code can also be reported when a physician or other qualified health care professional—including an audiologist or SLP—performs activities normally carried out by clinical staff, such as pre-visit screening or equipment and room cleaning.
Clinicians should report 99072 only:
The new code is available for immediate reporting on claims. However, CMS has not yet announced whether it will cover 99072 for Medicare services. Clinicians should check with state Medicaid programs and commercial insurers, as it may take payers some time to implement the new code for payment. ASHA is also advocating for payer coverage and implementation as soon as possible.
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