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    Health Service Code 13.99EB

    Medical Emergency Team Co-ordination by lead physician, per full 15 minutes or major portion thereof

    NOTE:
    1. Benefit includes patient assessment and necessary interventions including priority attendance, initial stabilization of patient with establishment of peripheral intravenous access, administration of oxygen, insertion of urinary catheter, initiation of appropriate medications and airway control for 'life-threatening' calling criteria.
    2. May only be claimed by a Critical Care Specialists whose role is to respond as part of a recognized hospital Rapid Response or Medical Emergency Team when patients fulfill activation criteria and where intervention by physician is required to prevent death or support failing organ systems.
    3. Concurrent claims for overlapping time for the same or different patients may not be claimed.
    4. If two claims for HSC 13.99EB at different encounters are submitted by the same or different physician, text is required.
    5. Two physicians may not claim HSC 13.99EB or 13.99E for concurrent care on the same day.
    Category:M Minor Procedure
    Base rate:$97.14

    AMA billing tips:

    • Each unit represents 15 minutes and may only be claimed for the total time that the physician spends providing personal and continuous MET attendance. This service is NOT claimed on cumulative time, the physician must be in attendance with the patient for the total time.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 15For Each Call Pay Base At100%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LVPLVP75YesReduce Base To75%

    Governing Rules:

    • 6.1

      If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.

    • 6.2

      If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.

    • 6.7.1

      If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.