Category: | V Visit |
---|---|
Base rate: | $365.63 |
Type | Code | # of calls | Explicit | Action | Amount |
---|---|---|---|---|---|
SURC | EV | Yes | Increase By | $48.70 | |
SURC | NTAM | Yes | Increase By | $116.83 | |
SURC | NTPM | Yes | Increase By | $116.83 | |
SURC | WK | Yes | Increase By | $48.70 |
When a claim is submitted for the following HSCs, the referring practitioner field must be completed with a valid referring practitioner number.
HSCs in the following list marked with an asterisk(*) cannot be self-referred. Self-referred means the physician is providing the diagnostic service and treating the patient.
HSCs in Section E (Lab and Pathology) and X (Diagnostic Radiology) require a valid referring practitioner number with the following exceptions: HSC X27D does not require a referral and HSC X27F may be self-referred. HSC 03.03D requires a valid referring physician, chiropractor, midwife, podiatrist, dentist, optometrist, physical therapist or nurse practitioner number when it is a visit to a referred patient.
01.01A | 01.01B | 01.03 | 01.04A | 01.05A | 01.09 |
01.12A | 01.12B | 01.14 | 01.16A | 01.16B | 01.16C |
01.22 | 01.22A | 01.22B | 01.22C | 01.24A | 01.24B |
01.24BA | 01.24BB | 01.32 | 01.34 | 02.82A | 02.84A |
02.84B |
10.04 | 10.08A | 10.33B | 13.99CC *13.99GA | 14.49A | |
14.82 | 14.85B | 14.88A | 14.88B | 15.94A | 16.83A |
16.83B | 16.83C | 16.89A | 16.92B | 17.81B | 19.81 |
22.81 | 24.89A | 24.89B | 28.8 A | 28.81A | 29.0 A |
30.81A | 33.22B | 37.81 | 37.82A | 37.82B | 38.89A |
38.89B | 39.21A | 39.62A | 39.83A |
40.92A | 41.29A | 41.29B | 42.09B | 43.81 | 43.82 |
44.3 B | 45.81A | 45.83 | 45.84B | 45.86A | 46.5 A |
46.81A | 46.82 | 46.84A | 46.88A | 48.92A | 48.98A |
48.98B | 49.93A | 49.95A | 49.96A | 49.96B | 49.98B |
49.98C | 49.98D |
50.81A | 50.81B | 50.81C | 50.81D | 50.81E | 50.82A |
50.82B | 50.83A | 50.84A | 50.84B | 50.84C | 50.87A |
50.87B | 50.87C | 50.88A | 50.89A | 50.89B | 50.89C |
50.89D | 50.89E | 50.91B | 50.95A | 50.95B | 50.98A |
52.1 A | 52.11A | 52.12 | 52.13 | 52.85A | 53.81A |
53.81B | 53.83A | 54.89A | 54.89B | 54.89D | 54.89E |
54.89F | 57.92A |
60.82C | 60.89A | 62.12A | 62.12B | 62.81A | 63.86A |
63.96B | 64.95A | 64.97A | 66.19A | 66.3 C | 66.83 |
66.89A | 66.89B | 66.89C | 67.81 | 67.86 | 67.87A |
67.89A | 68.95 | 69.83A | 69.83B | 72.91 | 72.92A |
74.82A | 75.83A | 76.89A | 78.7 A | 79.29E |
F7 |
When more than one procedure with a "V" category is provided at the same encounter only the greater benefit may be claimed.
The unscheduled service benefit (modifier SURC) may be claimed for the services outlined in GRs 15.9.1 through 15.9.3.
selected "V" category code services:
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