Table 7.

Example coding for pharmacist testing services based on medical coding for non-Medicare payers (information about coding from the medical model that payers may use to pay pharmacists for COVID-19 diagnostic testing and testing-related services)

ICD-10 coding
Z11.59		Asymptomatic, no known exposure, results unknown or negative
Z03.8181		Possible exposure to COVID-19, ruled out
Z20.828		Contact with COVID-19, suspected exposure
Assessment of patient or test ordering	Specimen collectiona	Test performed	Follow-up (telephonic) service code (02)
Pharmacist 99201 new patient 99212 established patient	Included in 99201 and 99212	87635 if done in pharmacy by pharmacist	Pharmacist: 99441 (5–10 min) 99442 (11–20 min) 99443 (21–30 min) Non-pharmacist: 98966 (5–10 min) 98967 (11–20 min) 98968 (21–30 min)
Other health professional (pharmacist will not bill for this)	99000a: pharmacist performs specimen collection 99001a: patient performs specimen collection	87635 if done in pharmacy by pharmacist	Pharmacist: 99441 (5–10 min) 99442 (11–20 min) 99443 (21–30 min) Nonpharmacist: 98966 (5–10 min) 98967 (11–20 min) 98968 (21–30 min)

Abbreviation used: COVID-19, coronavirus disease.

Note: Based on American Medical Association Guidance^58,59 and may be used by payers for pharmacists to bill for COVID-19 diagnostic testing and related services. Note that the use of billing codes is payer specific and depends on the pharmacist being recognized as a provider by the payer to be paid for the service.

^aIt is not clear if the CPT codes 99000 and 99001 can be used for specimen collection if not included in an Evaluation and Management Services code (99201 and 99212). It may need to be billed as a 99211.⁵⁹