Health Service Codes

Fee Navigator®

    Health Service Code 08.19CW

    Telephone or secure videoconference with a patient for scheduled psychiatric treatment (including group therapy) by a general practitioner or pediatrician, or for a palliative care or a chronic pain visit by an eligible physician, per full 15 minutes.

    NOTE:
    1. May only be claimed by General Practitioners or Pediatricians if the session is for scheduled psychiatric treatment.
    2. For non-scheduled psychiatric treatment, the appropriate office visit health service code should be claimed (HSC 03.03CV).
    3. May be claimed by any physician for palliative care. Palliative care is 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.
    4. May be claimed by any physician that is part of an interdisciplinary chronic pain program for a chronic pain visit. A chronic pain visit is 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. A chronic pain visit must be part of a comprehensive, coordinated, interdisciplinary program as defined in General Rule 4.2.5. A physician must be able to demonstrate that they have appropriate chronic pain training and experience.
    5. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    6. Only time spent communicating with the patient and/or the parent/guardian of a patient child can be claimed as part of the service. Time spent on administrative tasks cannot be claimed.
    7. May not be claimed on the same day as HSC 03.01AD, 03.01S, 03.01T, 03.03CV, 03.03FV, 03.05JR, 03.08CV, 08.19CV, or 08.19CX by the same physician for the same patient.
    8. May not be claimed on the same day as an in-person visit or consultation service by the same physician for the same patient.
    Common terms:
    • Virtual
    Category:V Visit
    Base rate:$47.54

    AMA billing tips:

    • Effective February 1, 2022, Physicians may claim for time spent discussing a child's treatment with a parent or guardian due to the child's inability to participate in the videoconference or telephone conversation.

      • Virtual group therapy to be claimed using this HSC., choose one patient and claim the total time providing group therapy under the one patient's PHN.
      • Record the start and stop time of the service in the patient record
      • Time premium is NOT billable in addition to this service.
      • Service must be provided by a physician
      • Patient initiated means that the patient or their agent requested to see the physician. If there are accommodations that need to be made in order to facilitate the request such as the physician calling the patient at a specific time, the service can still be claimed.
      • Will not count towards the daily cap
      • Other than patients located in NWT at the time of the service, virtual care codes cannot be claimed for patients located outside of AB at the time of the service.
      • Virtual care codes cannot be claimed under the medical reciprocal agreement.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGPReplace Base$47.54
    SKLLPEDReplace Base$50.10
    CALLM151 - 12For Each Call Pay Base At100%

    Governing Rules:

    • 19.1

      Daily patient volume payment rules will apply to visit services with a "V" category code (excluding HSC 03.01AD, 03.01N, 03.03CV, 03.03FV, 03.05LB, 03.08CV, 08.19CV, 08.19CW, 08.19CX, 08.44A, 08.44B, 08.44C, 08.44D, 13.59V, 13.59VA, 13.82A, 13.99AC, 13.99O and 13.99OA) that are provided in an office, home, or a non-registered facility.

      Excluding Grande Prairie and Fort McMurray, the daily patient volume payment rules will not apply to services provided in communities that are eligible for variable fee payments under the Rural Remote Northern Program.

      The total of all billings for eligible category "V" codes that are accepted for payment under the Alberta Health Care Insurance Plan will be calculated for each practitioner for each calendar day. When the daily total exceeds 50, the practitioner's payment on the category "V" codes that exceed 50 will be discounted by 50 percent. When the daily total exceeds 65, the practitioner's payment on the category "V" codes that exceed 65 will be discounted by 100 percent.

      Services will be assessed and payment/discounts will be applied to services in the order in which they are accepted for payment by the Alberta Health Care Insurance Plan.

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