| Category: | T Test |
|---|---|
| Base rate: | $9.41 |
Unless otherwise specified in this Schedule, HSCs designated with a T category code may be claimed with visits and consultations on the same day.
When a claim is submitted for the following HSCs, the referring practitioner field must be completed with a valid referring practitioner number.
HSCs in the following list marked with an asterisk(*) cannot be self-referred. Self-referred means the physician is providing the diagnostic service and treating the patient.
HSCs in Section E (Lab and Pathology) and X (Diagnostic Radiology) require a valid referring practitioner number with the following exceptions: HSC X27D does not require a referral and HSC X27F may be self-referred. HSC 03.03D requires a valid referring physician, chiropractor, midwife, podiatrist, dentist, optometrist, physical therapist or nurse practitioner number when it is a visit to a referred patient.
| 01.01A | 01.01B | 01.03 | 01.04A | 01.05A | 01.09 |
| 01.12A | 01.12B | 01.14 | 01.16A | 01.16B | 01.16C |
| 01.22 | 01.22A | 01.22B | 01.22C | 01.24A | 01.24B |
| 01.24BA | 01.24BB | 01.32 | 01.34 | 02.82A | 02.84A |
| 02.84B |
| 10.04 | 10.08A | 10.33B | 13.99CC 13.99GA* | 14.49A | |
| 14.82 | 14.85B | 14.88A | 14.88B | 15.94A | 16.83A |
| 16.83B | 16.83C | 16.89A | 16.92B | 17.81B | 19.81 |
| 22.81 | 24.89A | 24.89B | 28.8 A | 28.81A | 29.0 A |
| 30.81A | 33.22B | 37.81 | 37.82A | 37.82B | 38.89A |
| 38.89B | 39.21A | 39.62A | 39.83A |
| 40.92A | 41.29A | 41.29B | 42.09B | 43.81 | 43.82 |
| 44.3 B | 45.81A | 45.83 | 45.84B | 45.86A | 46.5 A |
| 46.81A | 46.82 | 46.84A | 46.88A | 48.92A | 48.98A |
| 48.98B | 49.93A | 49.95A | 49.96A | 49.96B | 49.98B |
| 49.98C | 49.98D |
| 60.82C | 60.89A | 62.12A | 62.12B | 62.81A | 63.86A |
| 63.96B | 64.95A | 64.97A | 66.19A | 66.3 C | 66.83 |
| 66.89A | 66.89B | 66.89C | 67.81 | 67.86 | 67.87A |
| 67.89A | 68.95 | 69.83A | 69.83B | 72.91 | 72.92A |
| 74.82A | 75.83A | 76.89A | 78.7 A | 79.29E |
| F7 |
Benefits for non-invasive diagnostic procedures including HSCs in Section E (Laboratory and Pathology) and X (Diagnostic Radiology) performed for a hospital inpatient, registered outpatient or AACC or UCC patient are not payable under the Schedule. Payment for these services is the responsibility of the hospital/Regional Health Authority. This applies to both the technical and professional components. Such procedures include but are not limited to the following list.
| 03.12A | 03.16A | 03.16B | 03.19C | 03.19D | 03.37A |
| 03.37B | 03.38A | 03.38B | 03.38C | 03.38D | 03.38E |
| 03.38F | 03.38G | 03.38H | 03.38K | 03.38M | 03.38N |
| 03.38P | 03.38Q | 03.38R | 03.38S | 03.38T | 03.38X |
| 03.39A | 03.39B | 03.41A | 03.41B | 03.41C | 03.41D |
| 13.99CC | 24.89A | 32.81 | 49.98T | 50.98A |
| 95.94C | 98.8 A | 98.89A | 98.89B | 98.89C | 98.89D |
| 98.89E | 98.89F | 98.89H | 98.92E | 98.99F |
| F7 |
Physicians performing procedures identified as Level I (HSCs 03.37A, 03.37B, 03.38D, 03.38E and 03.38R) do not require a completed Physician Skill Validation form. Physicians performing procedures identified as requiring either Level II, III or IV skill validation may only be claimed by physicians with the appropriate level of certification as confirmed by the completed Physician Skill Validation form signed by the applying physician and Medical Director of the facility validating the evaluation of the physician's professional competence, qualifications, and licensure.
In addition to Level I procedures, physicians with Level II approval may claim:
In addition to Level I and Level II procedures, physicians with Level III approval may claim:
