While physicians can bill payors for certain CPT codes for PPE and other COVID-related supplies, most payors are not reimbursing for them, leaving physicians to bear the brunt of these costs.

SB 242 by Senator Josh Newman would require a health plan or health insurer to contract with its health care providers to reimburse, at a reasonable rate, their business expenses that are medically necessary to render treatment to patients, to protect health care workers and to prevent the spread of diseases causing public health emergencies. The bill would also require the California Department of Health Care Services to similarly reimburse Medi-Cal providers, after undertaking a process to set reasonable rates in consultation with provider groups.

SB 242 (Newman) is currently in Senate Health Committee. The California Medical Association (CMA) is asking all committee members to vote AYE on SB 242.

For more information, read CMA supporting bill requiring payors to reimburse physicians for PPE.