Fee Navigator®

    Health Service Code 03.08B

    Obstetrical consultation - in office

    Category:V Visit
    Base rate:$93.36

    AMA billing tips:

    • Consultations may only be claimed when ALL of the following criteria have been met:

      • Patient is examined by referring provider (full list G.R. 4.4.1)
      • Referring provider specifically requests (verbal or written)opinion and or advice of consultant
      • Consultant performs:
      1. full history and
      2. full physical (relative to their specialty)
      3. may order lab or diagnostics.
      4. discusses treatment and advice with the patient and in some cases the referring provider
      5. provides referring provider with written report about recommendations, treatment, opinion.

      Consultations may NOT be claimed for transfer of care or pre operative assessments.

      Consultations are billable up to and including the day of surgery.

    • For clarity, if the patient had a comprehensive May 16th, 2018, the next comprehensive by the same physician is not technically eligible until May 16th of 2019.

      Alberta Health has relaxed the system rules to 345 days, be advised that this adjustment to the payment processing rules is intended to accommodate a small variance in patient/physician schedules; and not as permission to bill a comprehensive more frequently.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CARECMXC30YesIncrease Base By$31.43
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    TELETELESYesIncrease Base To120%

    Governing Rules: