Fee Navigator

    Health Service Code 03.03DF

    Visit to hospital in-patient in association with a callback

    NOTE:
    1. May be claimed when HSC 03.03D has been claimed at a different encounter by the same or different physician.
    2. May be claimed in addition to a special callback (HSC 03.03KA, 03.03LA, 03.03MC, 03.03MD) only where HSC 03.03D has been claimed for palliative or acute inter-current illness in an auxiliary hospital or nursing home.
    3. Claims for second and subsequent patients seen on a priority basis after initial callback (HSC 03.05N, 03.05P, 03.05QA, 03.05QB, 03.05R) must be made using HSC 03.03AR, if HSC 03.03D has already been claimed at a different encounter by the same or different physician.
    Category:V Visit
    Base rate:$44.45

    AMA billing tips:

    • 03.03DF is to be billed in addition to a call back for hospital in-patients:

      • 03.05N (0700-1700 weekdays)
      • 03.05P (1700-2200 weekdays)
      • 03.05QA (2200-2400 any day)
      • 03.05QB (2400-0700 any day)
      • 03.05R (0700-2200 weekends and stat holidays)

      03.01AA after hours time premium may be added to services provided after hours, see 03.01AA for more information)

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLCARDReplace Base$109.83
    SKLLCLIMReplace Base$55.64
    SKLLCRCMReplace Base$45.39
    SKLLDERMReplace Base$51.22
    SKLLE/MReplace Base$78.05
    SKLLGASTReplace Base$65.95
    SKLLHEMReplace Base$55.64
    SKLLIDISReplace Base$59.99
    SKLLINMDReplace Base$55.64
    SKLLMDGNReplace Base$60.12
    SKLLMDONReplace Base$55.64
    SKLLNEPHReplace Base$113.97
    SKLLNEURReplace Base$59.36
    SKLLNPMReplace Base$60.12
    SKLLPDGEReplace Base$65.95
    SKLLPEDReplace Base$60.12
    SKLLPEDCReplace Base$109.83
    SKLLPEDNReplace Base$113.97
    SKLLPHMDReplace Base$50.12
    SKLLRHEUReplace Base$48.32
    SKLLRSMDReplace Base$52.30

    Governing Rules:

    • 4.8.1

      If the services of more than one physician are required because of the complexity of the clinical needs of a patient, each physician may claim a benefit for concurrent care. Satisfactory supporting information must accompany the claim.

    • 4.8.2

      If a consultation is required, the attending physician and the consultant may each claim for services provided on the day of consultation.

    • 4.8.3

      If the provisions of GR 4.4.5 apply, a benefit may be claimed by the referring physician only after the full responsibility for the care of the patient has been returned to him/her, or the complexity of the clinical needs of the patient require the services of the referring physician in addition to those of the consultant.

    • 4.12.1

      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.

    • 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: HSC 03.02A, 03.03A, 03.03B, 03.04A, 03.03DF or 03.03EA.

    • 15.8

      Special callback benefits may not be claimed for subsequent patients seen during the same callback or in association with another service during the same encounter. However:

      1. HSC 03.03AR may be claimed for second and subsequent hospital inpatients.
      2. for second and subsequent emergency/outpatients, or AACC or UCC patients seen during the same callback, see GR 5.2.3.
      3. HSCs 03.03DF and 03.03EA may be claimed in addition to a callback in accordance with GR 15.5.