Fee Navigator®

    Health Service Code 03.03CV

    Assessment of a patient's condition via telephone or secure videoconference.

    NOTE:
    1. At a minimum a physician must complete a limited assessment of a patient's condition requiring a history related to the presenting problems, appropriate records, and advice to the patient. The total physician time spent providing patient care activities must last a minimum of 10 minutes. If the total physician time spent on the same day is less than 10 minutes, the service must be claimed using HSC 03.01AD.
    2. May only be claimed if the service was initiated by the patient or their agent (agent as defined in the Personal Directives Act).
    3. May only be claimed if the service is personally rendered by the physician.
    4. Benefit includes the ordering of appropriate diagnostic tests and procedures as well as discussion with the patient.
    5. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    6. Time spent on administrative tasks cannot be claimed.
    7. May not be claimed on the same day as HSC 03.01AD, 03.01S, 03.01T, 03.03FV, 03.05JR, 03.08CV, 08.19CV, 08.19CW, or 08.19CX by the same physician for the same patient.
    8. May not be claimed on the same day as an in-person visit or consultation service by the same physician for the same patient.
    Common terms:
    • Virtual
    Category:V Visit
    Base rate:$25.09

    AMA billing tips:

    • CMGP01, CMXV15 and CMXV20 have been added effective January 1, 2022.

      • Patient initiated means that the patient or their agent requested to see the physician. If there are accommodations that need to be made in order to facilitate the request such as the physician calling the patient at a specific time, the service can still be claimed.
      • Record the start and stop time of the service in the patient record
      • Must include a limited assessment of the patients condition. You must document all elements of the service, in the event of an audit AH will reduce the service to the lowest valued code.
      • Age modifiers and time premium are NOT billable in addition to this service.
      • Service must be provided by a physician
      • Will not count towards the daily cap.
      • Other than patients located in NWT at the time of the service, virtual care codes cannot be claimed for patients located outside of AB at the time of the service.
      • Virtual care codes cannot be claimed under the medical reciprocal agreement.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLANESReplace Base$25.63
    SKLLANPAReplace Base$40.84
    SKLLCARDReplace Base$54.13
    SKLLCLIMReplace Base$55.64
    SKLLCMSPReplace Base$55.64
    SKLLCRSGReplace Base$27.18
    SKLLCTSGReplace Base$27.18
    SKLLDERMReplace Base$37.65
    SKLLDIRDReplace Base$37.00
    SKLLE/MReplace Base$46.83
    SKLLEMSPReplace Base$30.63
    SKLLFTERReplace Base$30.63
    SKLLGASTReplace Base$65.95
    SKLLGNSGReplace Base$31.69
    SKLLGPReplace Base$38.03
    SKLLHEMReplace Base$55.64
    SKLLHEPAReplace Base$40.84
    SKLLIDISReplace Base$49.99
    SKLLINMDReplace Base$55.64
    SKLLMDBIReplace Base$40.84
    SKLLMDGNReplace Base$60.12
    SKLLMDMIReplace Base$40.84
    SKLLMDONReplace Base$55.64
    SKLLNCMDReplace Base$37.00
    SKLLNEPHReplace Base$78.90
    SKLLNEURReplace Base$45.51
    SKLLNPMReplace Base$60.12
    SKLLNUPAReplace Base$40.84
    SKLLNUSGReplace Base$34.80
    SKLLOBGYReplace Base$37.02
    SKLLOCMDReplace Base$55.64
    SKLLOPHTReplace Base$45.89
    SKLLORTHReplace Base$31.95
    SKLLOTOLReplace Base$34.70
    SKLLOVACReplace Base$45.89
    SKLLPATHReplace Base$40.84
    SKLLPDGEReplace Base$65.95
    SKLLPDNRReplace Base$60.12
    SKLLPDSGReplace Base$60.12
    SKLLPEDReplace Base$60.12
    SKLLPEDCReplace Base$60.12
    SKLLPEDNReplace Base$78.90
    SKLLPHMDReplace Base$60.14
    SKLLPLASReplace Base$62.19
    SKLLPSYCReplace Base$39.71
    SKLLRHEUReplace Base$47.26
    SKLLROSPReplace Base$38.03
    SKLLRSMDReplace Base$56.44
    SKLLTHORReplace Base$41.38
    SKLLUROLReplace Base$51.34
    SKLLVSSGReplace Base$25.09
    CARECMXV15YesIncrease Base By$15.70
    CARECMXV20YesIncrease Base By$15.70
    CMPXCMGP1YesFor Each Call Increase By$18.48

    Governing Rules:

    • 19.1

      Daily patient volume payment rules will apply to visit services with a "V" category code (excluding HSC 03.01AD, 03.01N, 03.03CV, 03.03FV, 03.05LB, 03.08CV, 08.19CV, 08.19CW, 08.19CX, 08.44A, 08.44B, 08.44C, 08.44D, 13.59V, 13.59VA, 13.82A, 13.99AC, 13.99O and 13.99OA) that are provided in an office, home, or a non-registered facility.

      Excluding Grande Prairie and Fort McMurray, the daily patient volume payment rules will not apply to services provided in communities that are eligible for variable fee payments under the Rural Remote Northern Program.

      The total of all billings for eligible category "V" codes that are accepted for payment under the Alberta Health Care Insurance Plan will be calculated for each practitioner for each calendar day. When the daily total exceeds 50, the practitioner's payment on the category "V" codes that exceed 50 will be discounted by 50 percent. When the daily total exceeds 65, the practitioner's payment on the category "V" codes that exceed 65 will be discounted by 100 percent.

      Services will be assessed and payment/discounts will be applied to services in the order in which they are accepted for payment by the Alberta Health Care Insurance Plan.