Fee Navigator®

    Health Service Code 03.05IZ

    Direct care, reassessment, education and/or general counselling of a patient requiring palliative care, per 15 minutes or portion thereof - out of office.

    Category:V Visit
    Base rate:$38.19

    AMA billing tips:

      • Physicians that provide care in publicly funded sites are required to bill the "Z" codes.
      • Publicly funded facility types are: acute care centres, ambulatory care centres, auxiliary hospital, Health Canada Nursing Station, nursing home, regional contracted practitioner office (offices that are contracted by AHS to provide specific services) and subacute auxiliary hospital.
      • Physicians that have an overhead arrangement with AHS and are required to bill the "Z" codes should get in touch with their Zone Medical Director to make arrangements to avoid "paying" overhead twice.
      • Please consult the Alberta Health Facility Directory for information regarding facility designations.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 96For Each Call Pay Base At100%
    TELETELESYesIncrease Base To120%

    Governing Rules:

    • 1.33

      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

    • 4.2.4

      Palliative Care: Defined as care given to a patient with a terminal disease such as cancer, AIDS or advanced neurologic disease. Palliative care involves active ongoing multi-disciplinary team care. Physicians involved in palliative care may claim for services provided under 03.05I, 03.05IZ, 03.05T and 03.05U as applicable.