Fee Navigator

    Health Service Code 03.04H

    Comprehensive visit in emergency department, 2200-0700 hours

    NOTE:
    1. HSCs 03.04F, 03.04G, 03.04H may only be claimed by emergency medicine physicians, full time emergency room physicians, general practitioners or pediatricians working a rotation duty shift in an emergency department with 24 hour on-site coverage or by physicians who are providing first call coverage in an emergency department that has greater than 25,000 visits to the emergency room per year.
    2. HSCs 03.04F, 03.04G, 03.04H may be claimed for those patients whose illness/injury requires prolonged observation, continuous therapy and multiple reassessments as described in GR 4.2.7 or for female patients requiring an internal examination because of obstetrical problems or gynecological bleeding.
    Category:V Visit
    Base rate:$99.19

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CARECMXC30YesIncrease Base By$31.43

    Governing Rules:

    • 4.2.7

      Comprehensive Visit in Emergency Department, AACC or UCC: An in-depth evaluation of a patient with a new or existing medical condition, including the recording of a complete history and a complete physical examination, and, where required, the ordering and reviewing of laboratory tests and x-rays and the initiation of appropriate therapy. May also be claimed for those patients whose illness or injury requires prolonged observation, continuous therapy and/or multiple reassessment(s) or for patients presenting with obstetrical problems or gynecological bleeding who require an internal examination. May be claimed by emergency medicine physicians, full-time emergency room physicians, general practitioners and pediatricians working a rotation duty shift in an emergency department with 24 hour on-site physician coverage or in an AACC or UCC with on-site coverage.