Fee Navigator®

    Health Service Code 08.19CV

    Telephone or secure videoconference with a patient for psychiatric treatment (including medical psychotherapy and medication prescription), psychiatric reassessment, patient education and/or psychiatric counseling, including group therapy, per 15 minutes or major portion thereof

    NOTE:
    1. May only be claimed by a psychiatrist (PSYC), a generalist in Mental Health (GNMH) or by a specialist in Mental Health (SPMH) 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.
    2. May be claimed for both referred and non-referred patients with psychiatric disorders.
    3. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    4. Only time spent communicating with the patient can be claimed as part of the service. Time spent on administrative tasks cannot be claimed.
    5. May not be claimed on the same day as 03.01AD, 03.01S, 03.01T, 03.03CV, 03.03FV, 03.05JR, 03.08CV, 08.19CW, or 08.19CX by the same physician for the same patient.
    6. May not be claimed on the same day as an in-person visit or consultation service by the same physician for the same patient.
    7. May only be claimed when a declaration of a public health emergency is made pursuant to 52.1(1), of the Public Health Act; or when the Chief Medical Officer of Health determines, in their discretion, that it is appropriate to implement this health service code even though a public health emergency has not been declared.
    Category:V Visit
    Base rate:$44.01

    AMA billing tips:

      • Group therapy to be claimed using this HSC.
      • 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.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$44.01
    SKLLPSYCReplace Base$55.92
    SKLLSPMHReplace Base$55.92
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM151 - 12For Each Call Pay Base At100%

    Governing Rules:

    No Governing Rules.