Anyone else run into this yet? My wife and I go to an Ortho practice and recently, first on 10/29/20 office visit, have been getting charged an extra $50 per in office visit for additional Covid 19 expenses. I have not called my insurance yet but I have received EOBs with note that this is not covered. On EOB it shows as CPT code 99072. My wife just finished up physical therapy and that would have cost us an extra $100 a week for two PT sessions she was doing.

I am not upset at doctors offices as I know Covid 19 has caused havoc with them but I am just wondering if anyone else is seeing this yet and if their insurance has been paying for it or not. Info in link below. Thanks for sharing any experiences. Hopefully I can at least get doctor's office to adjust charge down to a cash pay level. EOB shows insurance did not show any negotiated rate like it typically does for services charged which is often a fraction of what is originally "billed".

https://healthcare.traininglea...cpt-99072-covid-ppe/

"What Does 99072 Pay for?
Early in September, the AMA approved new CPT code 99072, to compensate you for the additional supplies, materials, and clinical staff time you spend on the following COVID-related activities:

Performing patient symptom checks over the phone and upon arrival (i.e. taking temperatures, asking questions, and providing distancing instructions)
Putting on and removing personal protective equipment (PPE)
Increased sanitation measures to prevent COVID spread, including cleaning supplies like hand sanitizer, disinfecting wipes, and more."

This message has been edited. Last edited by: grumpy1,

Yes it is happening. Insurance will NOT cover. Expenses in healthcare have gone through the roof due to COVID. A local dentist is charging an extra seven bucks for a COVID charge. It includes getting your temp taken, filling out a questionare, and a mask if needed while you sit in the waiting room. In my experience this is a business error. It really pisses off patients.

My favorite upscale restaurant is cutting the extras off the menu, like free desert, substitutions not permitted etc. It is more subtle and I understand.

I work in healthcare, and while my income is down significantly my expenses have greatly increased. I am absorbing the losses for the time being as I am confident things will bounce back next year. Self employment is never easy, but I would not want it any other way. Patients remember the little things like COVID upcharges.

Did some research and let me add the following:
November 3, 2020

The American Medical Association (AMA) published a new Current Procedural Terminology (CPT®) code on September 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency. CMS announced on October 27 it has assigned CPT 99072 procedure status “B.”

The code is effective immediately: CPT 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.

Some third-party payers have and will reimburse providers for this new CPT code, others won’t. Status "B" means:

there are no RVUs for this code;
CMS considers it to be bundled with whatever service was provided that day;
CMS’ contractors will not pay for this service;
providers may not bill the beneficiary for this service; and
issuing an Advanced Beneficiary Notice related to this service is not an option.
The CPT Editorial Panel creates CPT codes, but plays no role in developing payment for those codes. CPT is a registered trademark of the AMA.

Thanks so much for the info, much appreciated!

I've been to the dentist quite a bit this year and several doctor visits. I've never been charged for anything like that.

quote:

Originally posted by ZSMICHAEL:

there are no RVUs for this code;
CMS considers it to be bundled with whatever service was provided that day

Alphabet soup.

• RVU?
  
  
• CMS?

The other TLAs* that you used were defined, but not these two.

---

*TLA: Three Letter Acronym

One call to my doctor, "either make it go away or I'll never use you again"

Sounds to me like a bullshit charge.

quote:

Originally posted by ensigmatic:
Sounds to me like a bullshit charge.

Bingo! My (former) dentist started the $20 "Covid cleaning fee" this year for EVERY patient. You must pay PRIOR to even getting into the office. I had a long conversation with them 2 months ago and decided we were on different sides and because of the Covid fee and some other BS I fired them.

If I can get a reasonable explanation of why a separate charge needs to be added I will listen and then decide. Just to add it with no explanation would not sit well with me based on principle.

Without an explanation every business could be doing the same. There may be a perfectly good reason for a dentist or Dr. to charge but let’s hear the reasoning.

Sorry Vtail. RVU is:

RVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and comparing service volumes across all continuums. Traditionally reimbursement has predominately been based upon volume

CMS is the GOVERNMENT. It means Center for Medicare and Medicaid Services. It is extremely powerful as it sets fees doctors can charge and determines the procedures. Even if the doctor does not see Medicare patients, it comes into your life as other insurance companies use its figures to determine allowable procedures and fees. In my opinion it is akin to price fixing.

By bundling is meant including it in the evaluation and management codes and not charging extra.

Sometimes from a business viewpoint you have to absorb the extra cost and get it back later.

In a similar vein-I had to have daily wound care for 16 days this summer. My Dr is closed on Sunday, so I was forced to go to the only urgent care facility in two counties for treatment, or the emergency room. Unfortunately, as I found out later, the only medical staff working were Paki immigrants, out of my network. Each visit cost me 165 bucks. The ER would have charged me 100 and the treatment would have been covered.

We've not been hit with Covid charges, we just get denied service.

^^^^^^^^^^^^^^^
I hate this stuff, and have been caught in it myself. Many hospitals contract out ER services to different corporations such as TEAMHEALTH. Even though the hospital is in network the doctors in the ER are not. The current term is surprise billing.

So my question to my Doctor if I were charged this fee would be "is this your true cost or do you add a profit margin to it"
and "once this is over will you eliminate the cost to the your customers"

If it is really his "cost" and it is "temporary" I might not have a problem with it. If they add a profit and will keep it after this is over it is time to find a new Doctor.

You guys just realize that it your privilege to pay this extra fee to DO YOUR part to fight COVID.

Just one more small sacrifice.

(Yes, it is sarcasm)

Especially when it was NEVER our fault that the ccp crud came to the USA.

Charge china for those crud costs through increased tariffs.

quote:

Originally posted by ensigmatic:
Sounds to me like a bullshit charge.

Sounds like that everywhere.

quote:

Originally posted by ensigmatic:
Sounds to me like a bullshit charge.

Imagine sending them $50 worth of actual bullshit, with the purchase receipt, as "payment in full".

My guess is that it would not be well received. If it were the Veterans Administration you would be reported to the Disruptive Behavior Committee. All future appoitments if you are not banned would be in the company of security personnel. Some doctors just do not have a sense of humor. Personally go ahead. LOL

quote:

Originally posted by ZSMICHAEL:
If it were the Veterans Administration you would be reported to the Disruptive Behavior Committee. All future appoitments if you are not banned would be in the company of security personnel.

If it were the Veterans Administration, would this CPT 99072 "bullshit charge" be assessed?