Fee Navigator®

    Health Service Code 03.05U

    Second and subsequent physician attendance at formal, scheduled, professional interview relating to the care and treatment of a palliative care patient with other physicians, family and/or direct therapeutic supervision of allied health professionals or community agencies, on behalf of a specific patient, full 15 minutes or major portion thereof for the first call when only one call is claimed

    NOTE:

    This service is to be claimed in the name of the patient.

    Category:V Visit
    Base rate:$28.53

    AMA billing tips:

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

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 12For 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.

    • 4.2.4

      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.