On Sept. 8, the American Medical Association (AMA) rapidly released two new CPT codes related to the COVID-19 Public Health Emergency (PHE), effective immediately. The new codes are as follows:

• 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 PHE as defined by law, due to respiratory-transmitted infectious disease
• 86413 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative

Code 99072 represents a new practice expense code specifically meant to account for the additional supplies, materials, and clinical staff time required for patient symptom checks over the phone and upon arrival, donning and removing personal protective equipment (PPE), and increase sanitation measures to prevent the spread of communicable disease. It is intended for use in a non-facility setting. Code 86413 was created to report quantitative antibody detection for SARS-CoV-2.

Of note, these codes were created in September and are not listed in the 2021 Medicare Physician Fee Schedule, and it is uncertain how these codes may be paid by Medicare at this time. The College encourages clinicians to consider checking with their Medicare Administrative Contractors (MACs) and commercial payers for coverage and status.

For more information on both codes and usage instructions, view an AMA guide here. Also view AMA’s official statement addressing the new codes here, and a letter (see page 72) alongside information articulating the AMA/Specialty Society RVS Update Committee (RUC) recommendations to the Centers for Medicare and Medicare Services here.

Clinical Topics: COVID-19 Hub

Keywords: ACC Advocacy, Coronavirus, Current Procedural Terminology, COVID-19, American Medical Association, Medicare, Public Health, Personal Protective Equipment, severe acute respiratory syndrome coronavirus 2, Fee Schedules, Antibodies, Office Visits

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