Medicare Usage of CPT 99072
National Government Services has received many questions regarding CPT 99072 for Medicare usage since the AMA announced the code on 9/8/2020. Many providers have been asking if CMS will cover this code for Medicare billing.
CMS has issued a revision to CR11939 that is dated 10/27/2020. This CR addresses changes to the Medicare Physician Fee Schedule Database with the October 2020 update. CPT 99072 has been added to this CR with the below indication that is being added.
The following new CPT code is effective for dates of service 9/8/2020, and after.
| Code | Short Descriptor | Long Descriptor |
|---|---|---|
| 99072 | ADDL SUPL MATRL&STAF TM PHE | 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. |
On the MPFSDB file, code 99072 is Procedure Status B. There are no RVUs and payment policy indicators do not apply. The global days are XXX.
Based on this instruction, CMS has made it official that CPT 99072 is a bundled service and will not be payable by Medicare. As a reminder, Status B indicates the service is bundled into any other services provided so you may not bill the beneficiary for the services provided. Issuing an ABN is also not valid. These services are not separately payable by Medicare and the cost may not be transitioned to the beneficiary.
You may review this change and all of the October update in MLN Matters® MM11939 Revised: Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2020 Update
Posted 10/30/2020