Fee Navigator®

    Governing Rule: 15.9

    The unscheduled service benefit (modifier SURC) may be claimed for the services outlined in GRs 15.9.1 through 15.9.3.

    • 15.9.1

      selected "V" category code services:

      1. consultations, including telehealth (except those provided using store and forward videotechnology);
      2. intensive care unit visits (HSC 03.05A);
      3. psychiatric mental status determination requiring complete mental health status examination and investigation (HSC 08.11A);
      4. for complex patient, requiring complete mental status examination and investigation (HSC 08.11C);
      5. certification under the Mental Health Act (HSC 08.12A);
      6. trauma assessment, multiple trauma, severely injured patient (HSC 13.99GA);
      7. hyperbaric oxygen therapy detention time (HSC 13.99I);
      8. medical emergency detention (HSC 13.99J);
      9. management of complex labor, per 15 minutes (HSC 13.99JA);
      10. donor maintenance prior to cadaveric harvesting of organs (HSC 13.99L);
      11. examination and crisis counseling for sexual/physical abuse (HSC 13.99V);
      12. attendance at delivery (HSC 87.98E).
    • 15.9.2

      radiology, pathology and other diagnostic and therapeutic services if the physician is directly involved in the provision of services of an invasive nature;

    • 15.9.3

      procedures including surgical assists, obstetrical deliveries, anesthesia, major surgery and minor surgery.

    • 15.9.4

      The unscheduled service benefit (modifier SURC) may also be claimed for services outlined in GRs 15.9.1 through 15.9.3 when provided to second and subsequent patients seen during the same special call for attendance at the same facility.