New CPT code for PPE supplies during global pandemic
Since the pandemic's start, the AOA has worked to ensure that optometry is compensated for additional costs associated with PPE and now a new CPT code has been developed for PPE supplies.
To be implemented immediately, the new code—CPT 99072—describes 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.
While CPT 99072 is valued at $6.50 per patient, actual reimbursement may vary from state to state and insurance plan. The AOA is urging both CMS and all payers to immediately provide coverage for and pay these added costs.
The AOA recommends doctors report this new code to all payers but it‘s important to recognize that some payers may not reimburse these costs. Also, the AOA recommends doctors stop any use of CPT 99070 to report the extra cost of PPE. In accordance with appropriate coding guidelines, the newly developed code best reflects the clinical situation and should be used.
Any billing of the patient for this code should be done in accordance with your payer contracts. Also, be aware of state laws regarding charging patients for PPE costs. Doctors who bill third party payers for these costs must also charge private pay patients.
Looking for PPE?
The NOA, along with the AOA and some of our industry partners, has put together a list of suppliers for Personal Protective Equipment (PPE). You can find that list here.
Visit our COVID-19 section for the latest updates and resources including PPE.
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