Health Service Codes

Fee Navigator®

    Health Service Code 03.03BZ

    Prenatal visit - out of office.

    Category:V Visit
    Base rate:$38.34

    AMA billing tips:

      • Physicians that provide care in publicly funded sites are required to bill the "Z" codes.
      • Publicly funded facility types are: acute care centres, ambulatory care centres, auxiliary hospital, Health Canada Nursing Station, nursing home, regional contracted practitioner office (offices that are contracted by AHS to provide specific services) and subacute auxiliary hospital.
      • AHS and AH are conducting a review of physician overhead arrangements. Changes to the Z codes are expected to be implemented by October 1, 2020. In the meantime, there is still a requirement for physicians to claim the Z codes.
      • Please consult the Alberta Health Facility Directory for information regarding facility designations.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CARECMXV20YesIncrease Base By$15.74
    CARECMXV35YesIncrease Base By$31.51
    CMPXCMGP1 - 10YesFor Each Call Increase By$19.19
    TELETELESYesIncrease Base To120%

    Governing Rules:

    • 1.33

      An "in office" service is defined as a service that is not provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "in office": 03.03A, 03.03B, 03.03F, 03.04A, 03.05I, 03.07A, 03.08A, 03.08B, 03.08I, 03.08J, 08.19A, 08.19G, 08.19GA, and 08.45.

      An "out of office" service is defined as a service that is provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "out of office": 03.03AZ, 03.03BZ, 03.03FZ, 03.04AZ 03.05IZ, 03.07AZ, 03.08AZ, 03.08BZ, 03.08IZ, 03.08JZ, 08.19AZ, 08.19GZ, and 08.45Z

    • 4.2.2

      Limited Visit: A limited assessment, of a patient, which includes a history limited to and related to the presenting problem, and an examination which is limited to relevant body systems, an appropriate record, and advice to the patient. It includes the ordering of appropriate diagnostic tests and procedures as well as discussion with the patient.

    • 5.2.3

      Services provided to additional patients seen during the same callback, or services over the limits specified in GR 15.11 may be claimed as:

      1. Deleted
      2. HSC 03.02A, 03.03A, 03.03AZ, 03.03B, 03.03BZ, 03.04A, 03.04AZ as appropriate, or
      3. the applicable procedure.
    • 15.5

      Only one unscheduled service or special callback benefit may be claimed for each encounter with a patient. In the event of a special callback, the following visit services may be claimed in addition:

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