Fee Navigator®

    Health Service Code 08.19H

    Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of a psychiatric patient, on behalf of a specific patient, per 15 minutes or major portion thereof

    1. 08.19F and 08.19H may only be claimed by general practice physicians, generalists in Mental Health, pediatricians, psychiatrists and specialists in Mental Health.
    2. 08.19F and 08.19H are to be claimed using the Personal Health Number of the patient, naming the personnel, agencies or organizations involved.
    3. 08.19H may be claimed when the physician most responsible for the patient's care has submitted a claim under 08.19F.
    Category:V Visit
    Base rate:$29.62

    AMA billing tips:

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

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$34.99
    SKLLGPReplace Base$29.62
    SKLLPEDReplace Base$51.13
    SKLLPSYCReplace Base$46.42
    SKLLSPMHReplace Base$46.42
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM151 - 8For 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.

    • 4.11.1

      A physician may submit claims for group psychotherapy, psychiatric management and/or indirect services for the same patient on the same day.