PIP/Medical Billing – COVID Public Health Emergency (“PHE”) and CPT Code 99072

The Biden administration  extended  the public health emergency designation for the COVID 19 pandemic.  If you are a medical provider treating patients during a PHE, your clinic is entitled to bill CPT Code 99072 directly to the patient’s insurance company for each treatment.  CPT Code 99072 cannot be billed as a matter of course, the medical provider must be offering mask and have heightened procedures in place due to the PHE. 

CPT code 99072 was approved in response to measures adopted by medical practices and health care organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high-quality care during in-person interactions with health care professionals. The additional supplies and clinical staff time to perform safety protocols described by code 99072 allow for the provision of evaluation, treatment or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals.

The PHE creates the medical necessity for the treatment.  Considering this treatment is being provided in conjunction with treatment related to a motor vehicle accident it is undeniable that CPT Code 99072 is compensable.  If you are a medical provider and you billed CPT Code 99072 and the insurance company denied the code, call Quattrochi, Torres and Taormina for a FREE consultation.