Fee Navigator

    Health Service Code 03.05JR

    Physician telephone call directly to patient, to discuss patient management/diagnostic test results

    NOTE:
    1. A maximum of 14 telephone calls per physician, per calendar week may be claimed.
    2. May not be claimed for management of patient's anticoagulant therapy (billable under HSC 03.01N).
    3. May only be claimed when communication is provided by the physician.
    4. Documentation of the communication to be recorded in the patient record.
    5. May be claimed in addition to visits or other services provided on the same day, by the same physician.
    6. Neither HSCs 03.01S or 03.01T are payable if HSC 03.05JR is claimed in the same calendar week by the same physician for the same patient.
    Category:V Visit
    Base rate:$20.00

    AMA billing tips:

    • 03.05JR may be claimed when speaking with:

      • the parent or guardian of a pediatric patient
      • the primary caregiver of a patient with mental health concerns
      • an agent as defined by the Personal Directives Act

      03.05JR may not be claimed when the physician leaves a message for the patient.

      Alberta Health's payment system requires a different encounter numbers for 03.05JR and a visit item when they are provided on the same date of service. For example, if you are providing both services on the same, you would add a separate encounter number for the visit (encounter 1) and the 03.05JR (encounter 2). This is an exception as phone calls do not ordinarily need an encounter number.

    Fee modifiers:

    No modifiers.

    Governing Rules:

    No Governing Rules.