NOTE: 1. Use modifiers TDES, TEV, TNTA, TNTP, TST, TWK to claim for the after hours time unit premium in accordance with GR 15 and the SURT modifier definition. 2. Benefit will vary depending on the modifier used.

NOTE: Refer to notes following HSC 03.01NI.

NOTE: Refer to notes following HSC 03.01NI.

NOTE: 1. Active treatment facility worker may include registered: nurse, licensed practical nurse, midwife, occupational therapist, physiotherapist, speech language pathologist, social worker, pharmacist, psychologist, recreational therapist or respiratory therapist. 2. Long term care worker/hospice worker may include registered: nurse, licensed practical nurse, occupational therapist, physiotherapist, speech language pathologist, social worker, pharmacist, psychologist or recreational therapist. 3. Advice to nurse practitioners may only be claimed if the nurse practitioner is in autonomous practice or working at a nursing station where no physician is present. Advice to a public health nurse may only be claimed if the public health nurse is employed by AHS and working in an AHS health unit. 4. Advice to midwives may be claimed if the midwife is in independent practice or working at a midwifery center. 5. In the case of long term care or active treatment facility worker, claims may only be submitted when the physician is outside the facility where the patient is located. 6. May be claimed for advice given to midwife, hospice worker, home care worker or public health nurse in person as well as advice by telephone or other telecommunication methods. 7. HSCs 03.01NG, 03.01NH and 03.01NI are to be claimed using the Personal Health Number of the patient. 8. May only be claimed when the call is initiated by the long term care worker, assisted living/designated assisted living or lodge staff member, active treatment facility worker, home care worker, nurse practitioner, hospice worker, midwife, public health nurse or paramedic. 9. In the case of a long term care or hospice patient the call may be initiated by the physician if it is in response to receipt of diagnostic or other information that would affect the patient's treatment plan. 10. May be claimed in addition to visits or other services provided on the same day, by the same physician. 11. A maximum of two (any combination of HSC 03.01NG, 03.01NH, 03.01NI) claims may be made per patient, per physician, per day. 12. Documentation of the communication must be recorded in their respective records.

NOTE: Refer to the notes following HSC 03.01NL.

NOTE: Refer to the notes following HSC 03.01NL.

NOTE: 1. Active treatment facility worker may include registered: nurse, licensed practical nurse, occupational therapist, physiotherapist, speech language pathologist, social worker, pharmacist, psychologist, recreational therapist or respiratory therapist. 2. May only be claimed by hematology, infectious disease specialists, internal medicine and rheumatologists. 3. May only be claimed when the physician is outside the facility from where the patient is located. 4. May be claimed for advice given to the worker by telephone or other telecommunication means. 5. To be claimed using the Personal Health Number of the patient. 6. May only be claimed when the call is initiated by the health care worker. 7. A maximum of two (any combination of HSCs 03.01NJ, 03.01NK, 03.01NL) claims may be made per patient, per physician, per day. 8. Documentation of the communication must be recorded in their respective records.

NOTE: 1. It is expected that the purpose of the communication will be to seek the advice/opinion or to inform a physician when changes such as but not limited to prescription adaptations, pharmacist initiated prescriptions, care plans or medication reviews have occurred. 2. May only be claimed when the pharmacist has initiated the communication and the physician has provided an opinion or recommendation for patient treatment. 3. May not be claimed where the primary purpose of the communication is to clarify, decipher or interpret the physician's handwriting and/or written instructions. 4. May not be claimed for the authorization of repeat prescriptions for which long-term repeats would more properly have been authorized at the time of writing the initial prescription. 5. May not be claimed for instances where a physician directs a patient to request the pharmacist to contact the physician. 6. May not be claimed for patients in an active treatment, auxiliary, or nursing home facility. 7. May not be claimed when a physician proxy, e.g. nurse or clerk, provides advice to the pharmacist. 8. A maximum of one (1) communication per patient per day may be claimed, regardless of the number of issues or concerns discussed with the pharmacist. 9. Where more than one patient is discussed in a single communication, a claim may be submitted with respect to each patient discussed. 10. May be claimed in addition to visits or other services provided on the same day, by the same physician. 11. To be claimed using the Personal Health Number of the patient. 12. Documentation of the communication must be recorded in their respective records.

NOTE: Refer to notes following 03.01BB for further information.

NOTE: Refer to notes following 03.01BB for further information.

NOTE: 1. HSCs 03.01B, 03.01BA, 03.01BB are to be claimed using the Personal Health Number of the patient. 2. May only be claimed when the request for advice is initiated by the community mental health care worker, child protection worker, group home staff, or educational personnel. 3. May be claimed: -for advice provided in person or via telephone or other telecommunication methods. -in addition to visits or other services provided on the same day by the same physician. 4. A maximum of two (any combination of HSC 03.01B, 03.01BA, 03.01BB) claims may be claimed per patient, per physician, per day. 5. Documentation of the request and advice must be recorded by both the physician and the community mental health care worker in their respective patient records.

NOTE: 1. May only be claimed if the physician is required to be present at the referring site to assist with essential physical assessment without which the consultant service would be ineffective. 2. May be claimed in addition to other services provided in an emergency situation.

NOTE: May only be claimed when services are provided for an unrelated illness or injury in conjunction with a WCB-related service, including visits.

NOTE: 1. May only be claimed twice per calendar month, per patient, regardless of whether the same or different physician provides the service. 2. May only be claimed in months where advice has been given regarding dosage. 3. May be claimed in addition to visits or other services provided on the same day by the same physician. 4. May not be claimed for hospital inpatients or hospital outpatients. 5. Documentation of the communication must be recorded.

NOTE: 1. May only be claimed when both the referring physician or referring nurse practitioner and the consulting physician exchange communication using secure electronic communication that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/nurse practitioner/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta. 2. This service is only eligible for payment if the consultant physician has provided an opinion/advice and/or recommendations for patient treatment and/or management within thirty (30) days from the date of the e-consultation request. 3. May only be claimed when initiated by the referring physician or referring nurse practitioner. 4. The consultant may not claim a major consultation, physician to physician phone call, or procedure for the same patient for the same condition within 24 hours of receiving the request for an e-consultation unless the patient was transferred from an outside facility and advice was given on management of that patient prior to transfer. 5. May only be claimed when the consultant has provided an opinion and recommendations for patient treatment as well as management after reviewing pertinent family/patient history, history of the presenting complaint as well as laboratory and other data where indicated. It is expected that the purpose of the communication will be to seek the advice of a physician more experienced in treating the particular problem in question, and that the referring physician or referring nurse practitioner intends to continue to care for the patient. 6. May not be claimed for situations where the purpose of the communication is to: a. arrange for an expedited consultation or procedure within 24 hours except when the conditions in note 4 are met b. arrange for laboratory or diagnostic investigations c. discuss or inform the referring physician of results of diagnostic investigations. 7. Documentation of the request and advice given must be recorded by the consultant in their patient records. 8. This service may not be claimed for transfer of care alone. 9. Advice to nurse practitioners may only be claimed if the nurse practitioner is in autonomous practice or working in a nursing station where no physician is present.

NOTE: 1. Time spent completing the referral may not be claimed using complexity modifiers. 2. May only be claimed when both the referring and consulting physician exchange communication using secure electronic communication that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta. 3. May not be claimed for situations where the purpose of the communication is to: a) arrange for laboratory or diagnostic investigations b) discuss or inform of results of diagnostic investigations, or c) arrange for an expedited consultation with the patient 4. Documentation of the request and advice given must be recorded in the patient record. 5. This service may not be claimed for transfer of care alone.

NOTE: 1. May only be claimed for medically necessary advice or follow up where the nature of the condition can safely be managed via secure email. 2. May only be claimed when the service is provided using a secure email system that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta. 3. May only be claimed for those patients where an established physician-patient relationship exists and the physician has seen the patient in the previous 12 months. 4. Physicians and patients must have previously discussed and agreed to the limitations of health management using electronic means. 5. Secure electronic communication must inform patients when the physician is unavailable. 6. May only be claimed once per calendar week per patient per physician. 7. A maximum of fourteen 03.01S per calendar week per physician may be claimed. 8. A visit service may not be claimed if provided within 24 hours following the electronic communication. 9. HSC 03.01S is not payable in the same calendar week as 03.05JR or 03.01T by the same physician for the same patient. 10. May not be claimed when the service is provided by a physician proxy. 11. Documentation of the service must be recorded in the patients' record. 12. May not be claimed for inpatients.

NOTE: 1. May only be claimed for medically necessary advice or follow up where the nature of the condition can safely be managed via secure videoconference. 2. May only be claimed for those patients where an established physician-patient relationship exist and the physician has seen the patient in the previous 12 months. 3. May only be claimed when the service is provided using a secure videoconference system that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta. 4. May only be claimed once per calendar week per patient per physician. 5. A maximum of fourteen 03.01T per calendar week per physician may be claimed. 6. A visit service may not be claimed if provided within 24 hours following the electronic communication. 7. HSC 03.01T is not payable in the same calendar week as 03.05JR or 03.01S by the same physician for the same patient. 8. May not be claimed when the service is provided by a physician proxy. 9. Documentation of the service must be recorded in the patients' record. 10. May not be claimed for inpatients.

NOTE: Refer to notes following HSC 03.01LI.

NOTE: Refer to notes following HSC 03.01LI.

NOTE: 1. HSCs 03.01LG, 03.01LH, 03.01LI may be claimed in addition to visits or other services provided on the same day by the same physician when criteria listed below are met. 2. May only be claimed when the consultant has provided an opinion and recommendations for patient treatment as well as management after reviewing pertinent family/patient history and history of the presenting complaint as well as discussion of the patient's condition and management after reviewing laboratory and other data where indicated. It is expected that the purpose of the call will be to seek the advice of a physician or podiatric surgeon more experienced in treating the particular problem in question, and that the referring physician intends to continue to care for the patient. 3. May not be claimed for situations where the purpose of the call is to: - arrange for transfer of care that occurs within 24 hours unless the patient was transferred to an outside facility and advice was given on management of that patient prior to transfer - arrange for an expedited consultation or procedure within 24 hours - arrange for laboratory or diagnostic investigations - discuss or inform the referring physician or podiatric surgeon of results of diagnostic investigations. 4. A maximum of two (any combination of HSC 03.01LG, 03.01LH, 03.01LI) claims may be claimed per patient, per physician, per day. 5. Documentation must be recorded by both the referring physician and the consultant in their respective records. 6. Telehealth videoconferences may only be claimed when all participants are participating in the videoconference from regional telehealth facilities. 7. Claims for secure videoconference may only be claimed when the service is provided using a secure videoconference system that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service accepted by the Office of the Privacy Commissioner of Alberta.

NOTE: Refer to notes following HSC 03.01LL.

NOTE: Refer to notes following HSC 03.01LL.

NOTE: 1. HSCs 03.01LJ, 03.01LK, 03.01LL may only be claimed when initiated by the referring physician, nurse practitioner, midwife or podiatric surgeon. 2. The consultant may not claim a major consultation or procedure for the same patient for the same condition within 24 hours unless the patient was transferred from an outside facility and advice was given on management of that patient prior to transfer. 3. May only be claimed when the consultant has provided an opinion and recommendations for patient treatment as well as management after reviewing pertinent family/patient history and history of the presenting complaint as well as discussion of the patient's condition and management after reviewing laboratory and other data where indicated. It is expected that the purpose of the call will be to seek the advice of a physician more experienced in treating the particular problem in question, and that the referring physician, nurse practitioner, midwife or podiatric surgeon intends to continue to care for the patient. 4. May not be claimed for situations where the purpose of the call is to: -arrange for an expedited consultation or procedure within 24 hours except when the conditions in note 2 are met -arrange for laboratory or diagnostic investigations -discuss or inform the referring physician or podiatric surgeon of results of diagnostic investigations. 5. A maximum of two (any combination of HSC 03.01LJ, 03.01LK, 03.01LL) claims may be claimed per patient, per physician, per day. 6. Documentation must be recorded by both the referring physician, nurse practitioner, midwife or the podiatric surgeon and the consultant in their respective records. 7. Telehealth videoconferences may only be claimed when all participants are participating in the videoconference from regional telehealth facilities. 8. Claims for secure videoconference may only be claimed when the service is provided using a secure videoconference system that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service accepted by the Office of the Privacy Commissioner of Alberta. communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service accepted by the Office of the Privacy Commissioner of Alberta. 9. Advice to nurse practitioners may only be claimed if the nurse practitioner is in autonomous practice or working at a nursing station where no physician is present. 10. Advice to midwives may be claimed if the midwife is in independent practice or working at a midwifery center.

NOTE: Refer to the notes following HSC 03.01LO.

NOTE: Refer to the notes following HSC 03.01LO.

NOTE: 1. Active treatment facility worker may include Registered Nurse, Licensed Practical Nurse, midwife. 2. To be claimed using the Personal Health Number of the patient. 3. May only be claimed by general practice or obstetrics and gynecology. 4. Advice to nurse practitioners may only be claimed if the nurse practitioner is in independent practice or working at a nursing station where no physician is present. 5. May only be claimed when the physician is outside the facility from where the patient is located. 6. May only be claimed when the call is initiated by the active treatment facility worker or nurse practitioner. 7. May only be claimed for advice given to the active treatment facility worker or nurse practitioner by telephone or other telecommunication means. 8. A maximum of two (any combination of HSC 03.01LM, 03.01LN or 03.01LO) may be claimed per patient, per physician, per day. 9. Documentation of the communication must be recorded in their respective records.

NOTE: Refer to the notes following HSC 03.01LV

NOTE: Refer to the notes following HSC 03.01LV.

NOTE: 1. May only be claimed in those situations where the call to the OLMC physician has been dispatched through the STARS Link Centre, or a similar central dispatch centre for calls of this nature, on behalf of an EMS practitioner in attendance at an emergency situation where the EMS protocols, or the judgement of the EMS practitioner, necessitate contact with the OLMC physician. 2. May only be claimed when the OLMC physician has provided an opinion and recommendations for patient management to the EMS practitioner after reviewing the patient's history and condition with the EMS practitioner as well as review of laboratory and other data where indicated. 3. May not be claimed for situations where the purpose of the call is to: -arrange for an expedited consultation or procedure within 24 hours except when the conditions in note 2 are met. -arrange for laboratory or diagnostic investigations. 4. A maximum of two claims may be claimed per patient, per physician, per day. 5. Documentation of the phone call must be recorded in their respective records.