After-hours time premium 03.01AA in active treatment hospitals, nursing homes or auxiliary hospitals

The after-hours time premium is paid in addition to insured services provided in active treatment hospitals, nursing homes or auxiliary hospitals. The criteria are as follows:

• Patient must have been seen on the same date of service.
• Activities that are included in claiming for time: charting, reviewing but not waiting for lab or DI results, consulting with other health providers on the service about the patients care, writing a referral/consultant letter and any other activities that are included in managing the patients’ care.
• To be billed at the start of the encounter or during the time period where the bulk of the time was spent (e.g., for starting the encounter at 21:55 and ending at 22:10, claim 03.01AA TNTP01).
• If the time spent managing patients crosses over two time periods, more than one modifier can be used (e.g., for starting at 21:00 and ending at 23:45, claim 03.01AA TEV04 TNTP07).
• If the time spent managing patient care crosses two dates of service, separate the claim into two claims with two dates of service (e.g., for starting on day one at 21:00 and ending on day two at 03:45, claim 03.01AA TEV04 TNTP08 for day one, and 03.01AA TNTA15 for day two).

03.01AA may not be claimed for the following:

• Stand-by time.
• Completing discharge summaries or clinical notations, unless the patient was seen on that day.
• More than 4 units per hour per physician may not be claimed. Time claimed cannot exceed actual time spent managing patient care.
• Providing uninsured services.

Additional information

This HSC is claimed on a time basis and pays strictly for the time spent managing the patients’ care in relation to an insured service.

03.01AA is claimed in 15 minute units. A claim for 03.01AA must include a modifier that signals the time of day and the length of time it took to provide the service.

Modifiers that apply to 03.01AA are as follows and should not exceed 4 per hour:

• TEV (W/D 1700-2200), Maximum 20.
• TNTP (2200-2400), Maximum 8.
• TNTA (2400-0700), Maximum 28.
• TWK (W/E 0700-2200), Maximum 60.
• TST (0700-2200 stat holidays), Maximum 60.
• TDES (designated stat holidays 0700-2200), Maximum 60.