Fee Navigator

    Health Service Code 03.03D

    Hospital visits

    1. Specialist rates are for referred hospital visits only.
    2. A maximum of six level one days may be claimed when the same physician claims a comprehensive visit or consultation on the date of hospital admission.
    3. Only one HSC 03.03D may be claimed per patient, per physician, per day. Special callbacks (HSCs 03.05N, 03.05P, 03.05QA, 03.05QB, 03.05R) may be claimed when the criteria listed under HSC 03.05R are met.
    4. Modifier COINPT may be claimed for the management of complex acute care hospital inpatients with multi-system disease. Refer to the COINPT modifier definition for clarification regarding the use of this modifier.
    Category:V Visit
    Base rate:$42.26

    AMA billing tips:

    • The TOC modifier is added to visit service claims (03.03D) by the receiving physician to indicate a transfer of care from one physician to another.

      Adding the TOC modifier is only necessary if the transferring physician has claimed 03.03D on the same date of service as the receiving physician.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    LEVLCARDH1Replace Base$104.12
    LEVLCARDH2Replace Base$104.12
    LEVLCLIMH1Replace Base$55.64
    LEVLCLIMH2Replace Base$55.64
    LEVLCRCMH1Replace Base$45.39
    LEVLCRCMH2Replace Base$45.39
    LEVLDERMH1Replace Base$51.22
    LEVLDERMH2Replace Base$51.22
    LEVLE/M H1Replace Base$78.05
    LEVLE/M H2Replace Base$78.05
    LEVLGASTH1Replace Base$65.95
    LEVLGASTH2Replace Base$65.95
    LEVLGNSGH1Replace Base$42.26
    LEVLGNSGH2Replace Base$30.50
    LEVLHD1Replace Base$44.37
    LEVLHD2Replace Base$32.03
    LEVLHEMH1Replace Base$55.64
    LEVLHEMH2Replace Base$55.64
    LEVLIDISH1Replace Base$55.99
    LEVLIDISH2Replace Base$55.99
    LEVLINMDH1Replace Base$55.64
    LEVLINMDH2Replace Base$55.64
    LEVLMDGNH1Replace Base$60.12
    LEVLMDGNH2Replace Base$60.12
    LEVLMDONH1Replace Base$55.64
    LEVLMDONH2Replace Base$55.64
    LEVLNEPHH1Replace Base$87.67
    LEVLNEPHH2Replace Base$87.67
    LEVLNEURH1Replace Base$59.36
    LEVLNEURH2Replace Base$59.36
    LEVLNPMH1Replace Base$60.12
    LEVLNPMH2Replace Base$60.12
    LEVLPDGEH1Replace Base$65.95
    LEVLPDGEH2Replace Base$65.95
    LEVLPEDCH1Replace Base$104.12
    LEVLPEDCH2Replace Base$104.12
    LEVLPEDH1Replace Base$60.12
    LEVLPEDH2Replace Base$60.12
    LEVLPEDNH1Replace Base$87.67
    LEVLPEDNH2Replace Base$87.67
    LEVLPHMDH1Replace Base$50.12
    LEVLPHMDH2Replace Base$50.12
    LEVLRHEUH1Replace Base$49.15
    LEVLRHEUH2Replace Base$49.15
    LEVLRSMDH1Replace Base$52.30
    LEVLRSMDH2Replace Base$52.30
    CARECOINPTYesIncrease Base By$40.41
    LMTSTOCYesIncrease Base By

    Governing Rules: