Fee Navigator®

    Health Service Code 03.03FA

    Prolonged repeat office or scheduled outpatient visit in a regional facility, referred cases only, full 15 minutes or portion thereof for the first call when only one call is claimed

    NOTE:
    1. May only be claimed in addition to HSC 03.03F or 03.03FZ when the 03.03F or 03.03FZ exceeds 30 minutes.
    2. May only be claimed by pediatrics (including subspecialties) and clinical immunology and allergy for patients 18 years of age and under, or by cardiology, endocrinology/metabolism, gastroenterology, infectious diseases, internal medicine, hematology, medical genetics, medical oncology, neurology, physiatry, respiratory medicine, rheumatology, urology and vascular surgery (no age restriction).
    Category:V Visit
    Base rate:$25.09

    AMA billing tips:

    • The rate of $7.38 for NEUR is not an error, but an achievable first step of the implementation of the NEUR skill code for this service, using funds available to the section for the November 1, 2018 changes. This rate is expected increase to around $60 over time, once the fee is at functional INRV

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLCARDReplace Base$61.25
    SKLLCLIMReplace Base$47.69
    SKLLE/MReplace Base$28.85
    SKLLGASTReplace Base$25.58
    SKLLHEMReplace Base$47.69
    SKLLIDISReplace Base$59.99
    SKLLINMDReplace Base$47.69
    SKLLMDGNReplace Base$60.12
    SKLLMDONReplace Base$47.69
    SKLLNEURReplace Base$7.38
    SKLLNPMReplace Base$60.12
    SKLLPDGEReplace Base$60.12
    SKLLPDNRReplace Base$60.12
    SKLLPEDReplace Base$60.12
    SKLLPEDCReplace Base$61.25
    SKLLPEDNReplace Base$60.12
    SKLLPHMDReplace Base$76.18
    SKLLRHEUReplace Base$35.43
    SKLLRSMDReplace Base$49.35
    SKLLUROLReplace Base$59.89
    SKLLVSSGReplace Base$25.09
    CALLM151 - 4For Each Call Pay Base At100%
    TELETELESYesIncrease Base To120%

    Governing Rules: