| Category: | V Visit |
|---|---|
| Base rate: | $40.14 |
03.04A may not be claimed for registered hospital inpatients.
| Type | Code | # of calls | Explicit | Action | Amount |
|---|---|---|---|---|---|
| SKLL | ANES | Replace Base | $72.00 | ||
| SKLL | ANPA | Replace Base | $85.69 | ||
| SKLL | CARD | Replace Base | $96.75 | ||
| SKLL | CLIM | Replace Base | $176.78 | ||
| SKLL | CMSP | Replace Base | $176.78 | ||
| SKLL | CRSG | Replace Base | $106.84 | ||
| SKLL | CTSG | Replace Base | $106.84 | ||
| SKLL | DERM | Replace Base | $47.36 | ||
| SKLL | DIRD | Replace Base | $66.46 | ||
| SKLL | E/M | Replace Base | $121.70 | ||
| SKLL | EMSP | Replace Base | $53.92 | ||
| SKLL | FTER | Replace Base | $53.92 | ||
| SKLL | GAST | Replace Base | $88.69 | ||
| SKLL | GNSG | Replace Base | $63.59 | ||
| SKLL | GP | Replace Base | $106.60 | ||
| SKLL | HEM | Replace Base | $176.78 | ||
| SKLL | HEPA | Replace Base | $85.69 | ||
| SKLL | IDIS | Replace Base | $131.56 | ||
| SKLL | INMD | Replace Base | $176.78 | ||
| SKLL | MDBI | Replace Base | $85.69 | ||
| SKLL | MDGN | Replace Base | $121.54 | ||
| SKLL | MDMI | Replace Base | $85.69 | ||
| SKLL | MDON | Replace Base | $176.78 | ||
| SKLL | NCMD | Replace Base | $66.46 | ||
| SKLL | NEPH | Replace Base | $157.81 | ||
| SKLL | NEUR | Replace Base | $148.40 | ||
| SKLL | NPM | Replace Base | $121.54 | ||
| SKLL | NUPA | Replace Base | $85.69 | ||
| SKLL | NUSG | Replace Base | $53.54 | ||
| SKLL | OBGY | Replace Base | $62.24 | ||
| SKLL | OCMD | Replace Base | $176.78 | ||
| SKLL | OPHT | Replace Base | $97.93 | ||
| SKLL | ORTH | Replace Base | $61.53 | ||
| SKLL | OTOL | Replace Base | $51.88 | ||
| SKLL | OVAC | Replace Base | $97.93 | ||
| SKLL | PATH | Replace Base | $85.69 | ||
| SKLL | PDGE | Replace Base | $121.54 | ||
| SKLL | PDNR | Replace Base | $148.40 | ||
| SKLL | PDSG | Replace Base | $121.54 | ||
| SKLL | PED | Replace Base | $121.54 | ||
| SKLL | PEDC | Replace Base | $121.54 | ||
| SKLL | PEDN | Replace Base | $157.81 | ||
| SKLL | PHMD | Replace Base | $100.24 | ||
| SKLL | PLAS | Replace Base | $90.83 | ||
| SKLL | RHEU | Replace Base | $101.35 | ||
| SKLL | ROSP | Replace Base | $106.60 | ||
| SKLL | RSMD | Replace Base | $93.12 | ||
| SKLL | THOR | Replace Base | $41.61 | ||
| SKLL | UROL | Replace Base | $68.91 | ||
| SKLL | VSSG | Replace Base | $40.14 | ||
| CARE | CMXC30 | Yes | Increase Base By | $31.43 | |
| TELE | TELES | Yes | Increase Base To | 120% |
An "in office" service is defined as a service that is not provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "in office": 03.03A, 03.03B, 03.03F, 03.04A, 03.05I, 03.07A, 03.08A, 03.08B, 03.08I, 03.08J, 08.19A, 08.19G, 08.19GA, and 08.45.
An "out of office" service is defined as a service that is provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "out of office": 03.03AZ, 03.03BZ, 03.03FZ, 03.04AZ 03.05IZ, 03.07AZ, 03.08AZ, 03.08BZ, 03.08IZ, 03.08JZ, 08.19AZ, 08.19GZ, and 08.45Z
In the context of GR 4, complete physical examination shall include examination of each organ system of the body, except in psychiatry, dermatology and the surgical specialties. "Complete physical examination" shall encompass all those organ systems which customarily and usually are the standard complete examination prevailing within the practice of the respective specialty. What is customary and usual may be judged by peer review.
Comprehensive Visit: An in-depth evaluation of a patient. This service includes the recording of a complete history and performing a complete physical examination appropriate to the physician's specialty, an appropriate record and advice to the patient. It may include the ordering of appropriate diagnostic tests and procedures as well as discussion with the patient. Advice to the patient must include discussion of a care plan related to the patient's condition(s). Patient care advice, including the discussed care plan, must be documented in the patient's record. The care plan does not have to be formally signed by the patient.
Comprehensive Consultation: An in-depth evaluation of a patient with a written report to the referring physician, audiologist, Alberta registered midwife, chiropractor, podiatrist, dentist, optometrist, physical therapist or nurse practitioner. This service includes the recording of a complete history, performing a complete physical examination appropriate to the physician's specialty, an appropriate record and advice to the patient. It may include the ordering of appropriate diagnostic tests and procedures as well as discussion with the patient and/or the referring physician, audiologist, midwife, chiropractor, podiatrist, dentist, optometrist, physical therapist or nurse practitioner.
Comprehensive visits and/or comprehensive/major consultations may only be claimed once every 365 days per patient by the same physician. Comprehensive visit and consultation services are defined as HSCs 03.04A, 03.04AZ, 03.08A, 03.08AZ, 03.08B, 03.08BZ, 03.08C, 03.08CV, 03.08F, 03.08H, 03.08K, 08.11A, 08.11C, 08.19A, 08.19AZ, 08.19AA, and 08.19CX.
HSC 03.09B is defined as comprehensive and may not be billed more frequently than once every 180 days by the same physician.
HSCs 03.04O and 03.04P are defined as comprehensive services and may not be
billed more frequently than four times per year as indicated or within 180 days of a comprehensive service or consultation by the same physician.
Three technical services and three interpretive services from the following examinations may be claimed in addition to HSCs 03.04A, 03.04AZ, 03.08A, 03.08AZ, 03.08H and 09.04:
09.13E Optical coherence tomography (OCT), interpretation 09.13F Optical coherence tomography (OCT), technical 09.26A Diurnal tension curve 09.26D Bilateral corneal pachymetry 21.31A Diagnostic irrigation of nasolacrimal duct, office procedure, per eye 24.89B Diagnostic conjunctival scraping 25.81A Diagnostic corneal scraping
