Fee Navigator®

    Health Service Code 03.05JN

    Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of multiple patients undergoing rehabilitation therapy including those with chronic pain, when discussion occurs on behalf of a specific patient per full 5 minutes to a maximum of 6 units in a 30 minute period

    1. HSC 03.05JM may only be claimed by Physiatry.
    2. HSC 03.05JN may be claimed by any physician that is participating in the conference.
    3. HSCs 03.05JM and 03.05JN are to be claimed using the Personal Health Number of the patient.
    4. HSC 03.05JN may be claimed when the physician most responsible for the patient's care has submitted a claim under 03.05JM.
    Category:V Visit
    Base rate:$14.54

    AMA billing tips:

    • This team conference may be claimed when provided via telephone or secure videoconference.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM051 - 36For Each Call Pay Base At100%
    TELETELESYesIncrease Base To120%

    Governing Rules:

    • 2.8.1

      Team conferences related to the care and treatment of a patient with other physician(s), allied health professionals, educational, correctional, and other community agencies may be claimed if provided via telephone or secure videoconference. Such services include 03.05JA, 03.05JD, 03.05JJ, 03.05JM, 03.05JN, 03.05T, 03.05U, 03.05V, 03.05W, 03.05Y, 03.05YM, 08.19F, 08.19H, 08.19J, and 08.19K.

    • 4.2.5

      Chronic Pain: Defined as pain which persists past the normal time of healing, is associated with protracted illness or is a severe symptom of a recurring condition. Interdisciplinary Chronic Pain Program: Defined as a comprehensive, coordinated, interdisciplinary program for persons complaining of chronic pain. The interdisciplinary team consists of a medical director; other team members will include psychologist(s) and/or psychiatrist(s), physiotherapist(s) and/or occupational therapist(s) and may include anesthetist(s) and other professional personnel. Treatment is delivered by a coordinated team within the same site by an interdisciplinary chronic pain program.