Fee Navigator®

    Health Service Code 08.19GZ

    Direct contact with an individual patient for psychiatric treatment (including medical psychotherapy and medication prescription), psychiatric reassessment, patient education and/or psychiatric counselling, per 15 minutes or major portion thereof - out of office.

    NOTE:
    1. May be claimed:
      • if the intent of the session is the therapy of one individual patient, whether or not more than one person is involved in the session.
      • when a physician assessment has established (during the same or previous visit) that the patient is suffering from a psychiatric disorder.
    2. For treatment of non-psychiatric disorders, the appropriate office visit health service code should be claimed.
    3. May not be claimed at the same encounter as HSCs 08.11A, 08.11C, 08.19A, 08.19AA, 08.19B, 08.19BB, 08.19C, 08.19CC or 08.19AZ.
    Category:V Visit
    Base rate:$44.01

    AMA billing tips:

      • Physicians that provide care in publicly funded sites are required to bill the "Z" codes.
      • Publicly funded facility types are: acute care centres, ambulatory care centres, auxiliary hospital, Health Canada Nursing Station, nursing home, regional contracted practitioner office (offices that are contracted by AHS to provide specific services) and subacute auxiliary hospital.
      • AHS and AH are conducting a review of physician overhead arrangements. Changes to the Z codes are expected to be implemented by October 1, 2020. In the meantime, there is still a requirement for physicians to claim the Z codes.
      • Please consult the Alberta Health Facility Directory for information regarding facility designations.
    • When providing psychotherapy and non psychotherapy services at the same encounter, only ONE claim for a visit service may be submitted for payment. Either the psychotherapy service or the visit service (03.03A, 03.03AZ, 03.03F, 03.03FZ etc.). The claim should reflect the service where the majority of the time was spent providing services. Reminder that 08.19G and 08.19GZ only include direct face-to-face time, extended time may not be claimed for indirect services.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$44.01
    SKLLGPReplace Base$47.54
    SKLLPEDReplace Base$50.10
    SKLLPSYCReplace Base$55.92
    SKLLSPMHReplace Base$55.92
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM151 - 12For Each Call Pay Base At100%
    TELETELESYesIncrease Base To120%

    Governing Rules:

    • 1.33

      An "in office" service is defined as a service that is not provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "in office": 03.03A, 03.03B, 03.03F, 03.04A, 03.05I, 03.07A, 03.08A, 03.08B, 03.08I, 03.08J, 08.19A, 08.19G, 08.19GA, and 08.45.

      An "out of office" service is defined as a service that is provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "out of office": 03.03AZ, 03.03BZ, 03.03FZ, 03.04AZ 03.05IZ, 03.07AZ, 03.08AZ, 03.08BZ, 03.08IZ, 03.08JZ, 08.19AZ, 08.19GZ, and 08.45Z