Fee Navigator®

    Governing Rule: 4.13


    • 4.13.1

      The benefit for care of a healthy newborn in hospital does not apply when the infant is ill. In these circumstances, the daily hospital visit HSCs apply.

    • 4.13.2

      If a physician performs the delivery and resuscitates the infant, HSC 13.99F may be claimed in addition to a delivery benefit.

    • 4.13.3

      The benefit for care of a healthy newborn in hospital may be claimed by the same physician who claimed the benefit for the delivery.

    • 4.13.4

      If newborn and premature care is provided by a physician other than a pediatrician,

      1. the benefit for care of a healthy newborn may be claimed under HSC 03.05G whether or not the case is received as a referral;
      2. if a consultation is required, a claim under HSC 03.05G may be claimed by the attending physician and a consultation benefit by the consultant;
      3. if a newborn requires transfer to a consultant, a benefit to the attending physician may be claimed on a fee for service basis, and
      4. subject to GR 4.13.5 routine care of a healthy premature newborn may be claimed as applicable visit HSCs.
    • 4.13.5

      Routine care is considered to include minor conditions.

    • 4.13.6

      Routine follow-up visits provided for a premature infant after 90 days and 180 days of age may each be claimed under HSC 03.03A, 03.03AZ or its equivalent.