Fee Navigator

    Governing Rule: 15.13

    AFTER HOURS TIME PREMIUM - HOSPITAL INPATIENT, OUTPATIENT AND EMERGENCY

    DEPARTMENTS, AACCs, UCCs, AUXILIARY HOSPITALS AND NURSING HOMES

    • 15.13.1

      Benefits for the AFTER HOURS TIME PREMIUM (modifier SURT) are intended to provide physicians with compensation for services provided after hours during:

      • the evening on weekdays (1700 - 2200 hours),
      • the day and evening on weekends and statutory holidays (0700 - 2200 hours),
      • any night of the week (2200 - 0700 hours).
    • 15.13.2

      The after hours time premium modifier applies to both scheduled and unscheduled services. In the case of unscheduled services, the unscheduled services modifier will also apply according to GRs 15.3 through 15.10.6.

    • 15.13.3

      Deleted

    • 15.13.4

      The after hours time premium modifier is to be claimed on a per 15 minute basis beginning at the time of contact with the patient and may only be claimed for direct patient care time related to the provision of an insured service. The after-hours time premium units may not be claimed for stand by time, e.g. time spent waiting for results of diagnostic tests.

    • 15.13.5

      Time for the after hours time premium may be determined on a cumulative basis, and claimed according to the time period(s) in which the majority of the service occurred. HSC 03.01AA should be used to claim the after-hours time modifier for all services.

    • 15.13.6

      In the event that one 15 minute period covers two time periods, the modifier claimed will be based on the time period where the majority of the 15 minute period occurred.

    • 15.13.7

      In the event that the time spent with the patient covers more than one time period, additional modifiers may be claimed, each according to the time spent with the patient in that particular time period.

    • 15.13.8

      Deleted

    • 15.13.9

      The after hours time premium modifier may not be claimed for:

      • stand-by time;
      • non-invasive diagnostic procedures.
    • 15.13.10

      The maximum number of after hours time premium modifiers per hour, per physician is 4.