Health Service Codes

Fee Navigator®

    Health Service Code 03.03FV

    Repeat office visit or scheduled outpatient visit, referred cases only 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 patient management activities on the same day is less than 10 minutes the services must be claimed using HSC 03.01AD.
    2. May only be claimed if the service is personally rendered by the physician.
    3. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    4. Time spent on administrative tasks cannot be claimed.
    5. May not be claimed on the same day as HSC 03.01AD, 03.01S, 03.01T, 03.03CV, 03.05JR, 03.08CV, 08.19CV, 08.19CW or 08.19CX by the same physician for the same patient.
    6. 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:$32.34

    AMA billing tips:

    • 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.
      • "referred patients" means the patient was initially referred to a physician and the physician is continuing to care for the patient for their condition.
      • 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 claim to the lowest valued service.
      • 03.03FA, and time premium are NOT billable in addition to this service.
      • Only specialists that have a skill code listed can bill for the 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.
      Read more

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLCARDReplace Base$103.25
    SKLLCLIMReplace Base$63.58
    SKLLCRCMReplace Base$32.34
    SKLLE/MReplace Base$80.13
    SKLLGASTReplace Base$65.95
    SKLLHEMReplace Base$63.58
    SKLLIDISReplace Base$59.99
    SKLLINMDReplace Base$63.58
    SKLLMDGNReplace Base$100.20
    SKLLMDONReplace Base$63.58
    SKLLNEPHReplace Base$87.67
    SKLLNEURReplace Base$67.23
    SKLLNPMReplace Base$100.20
    SKLLPDGEReplace Base$100.20
    SKLLPDNRReplace Base$100.20
    SKLLPEDReplace Base$100.20
    SKLLPEDCReplace Base$103.25
    SKLLPEDNReplace Base$100.20
    SKLLPHMDReplace Base$115.27
    SKLLRHEUReplace Base$66.30
    SKLLRSMDReplace Base$98.95
    SKLLUROLReplace Base$51.34
    SKLLVSSGReplace Base$50.17
    CARECMXV15YesIncrease Base By$15.70
    CARECMXV20YesIncrease Base By$15.70

    Governing Rules:

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