Insurance Updates

Use of CPT Code 99080 to Offset Electronic Submission Costs in New York Workers’ Compensation 

Healthcare providers submitting claims under New York Workers’ Compensation may now offset the cost associated with using an electronic submission partner by billing CPT code 99080. This provision allows providers to recover a portion of administrative expenses incurred during the electronic transmission of CMS-1500 forms. 

Code Background 

CPT code 99080 is defined in the Official New York Workers’ Compensation Medical Fee Schedule as: “Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form.” 

Historically listed as a No Charge (NC) item, code 99080 is now billable on a By Report (BR) basis for the specific purpose of cost-offsetting electronic submission.