Fee Navigator®

    Health Service Code 08.19CX

    Formal major psychiatric consultation via telephone or secure videoconference, first full 30 minutes or major portion thereof for the first call when only one call is claimed

    1. Each subsequent 15 minutes, or major portion thereof, may be claimed at the rate specified on the Price List after the first full 30 minutes has elapsed.
    2. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    3. Communication 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.
    4. 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 08.19CW by the same physician for the same patient.
    5. 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:$53.22

    AMA billing tips:

    • Indirect care for 08.19CX maybe included in the total time claimed. When completed on the same date of service as the consultation, activities such as reviewing patient charts, completing referrals etc., may be included in the total time claimed.

      • Physicians may claim for time spent discussing the child's treatment with a parent or guardian due to the child's inability to participate in the videoconference or telephone conversation.
      • Patient must be referred, See GR's 4.3 and 4.4
      • Referrals by registered: occupational therapist, psychologist, community based psychiatric nurse, social worker or speech language pathologist, may be claimed using 08.19CX.
      • Only billable by PSYC and GNMH
      • Record the start and stop time of the service in the patient record
      • Surcharge modifiers and time premium are NOT billable in addition to this service.
      • Service must be provided by a physician
      • Will not count towards the daily cap.
    • 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$53.22
    SKLLPSYCReplace Base$189.58
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM30M151For Each Call Pay Base At100%
    CALLM30M152 - 11For Each Call Increase By$52.97

    Governing Rules: