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

    NOTE:
    1. Each subsequent 15 minutes, or major portion thereof, of direct patient time 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. Only time spent communicating with the patient 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 03.01AD, 03.01S, 03.01T, 03.03CV, 03.03FV, 03.05JR, 03.08CV, 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.
    6. 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:$52.22

    AMA billing tips:

      • Patient must be referred, See GR's 4.3 and 4.4
      • 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.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$52.22
    SKLLPSYCReplace Base$189.58
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM30M151For Each Call Pay Base At100%
    CALLM30M152 - 11For Each Call Increase By$52.95

    Governing Rules:

    No Governing Rules.