Fee Navigator

    Health Service Code 03.03EA

    Visit to long term care patient in association with a special callback (HSC 03.03KA, 03.03LA, 03.03MC, 03.03MD)

    Category:V Visit
    Base rate:$66.56

    AMA billing tips:

    • Update Jan 21, 2019 -The Base Rate for this code has been corrected, claims for services for 03.03EA between November 1, 2018 and Jan 21, 2019 will be reassessed and paid at the corrected rate in May 2019.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLPHMDReplace Base$115.27

    Governing Rules:

    • 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.