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    Health Service Code 13.99J

    Medical emergency detention time, per 15 minutes

    NOTE:
    1. Time may be claimed on a cumulative basis per day (defined as 0001 to 2400), and may include time spent with the patient, review of patient history including diagnostics, review of patient prescriptions and other activities the physician does in relation to the patient's care on the same date of service.
    2. Time spent providing services compensated elsewhere in the Schedule, e.g., family conferences and procedures, may not be included in time claimed for HSC 13.99J.
    3. Supporting information must be submitted.
    4. May be claimed by a physician during the time he/she is medically required to personally and continuously attend and treat an illness or injury of an emergency nature.
    5. May not be claimed for such services as:
      • counseling or psychotherapy except for crisis intervention situations;
      • waiting for the results of laboratory or radiological examination;
      • giving advice to family members or the patient;
      • waiting for a family physician or consultant;
      • attendance at labour or fetal monitoring (see HSC 13.99JA);
    6. Detention time may not be claimed if the service was provided in the office in conjunction with routine visits except when it is documented that an emergency existed.
    7. Illness of an "emergency nature" may apply to mental or emotional disorders as well as to physical illness.
    8. If a visit benefit is claimed, the detention time benefit may not be claimed until thirty minutes after the start of the visit.
    9. Only HSC 13.99J or procedures provided during the same encounter (with the exception of HSC 13.99E) may be claimed, but not both. Concurrent claims for overlapping time for the same or different patients may not be claimed.
    10. A maximum of 16 calls per physician per day may be claimed in any location other than a physician's office.
    11. A maximum of 8 calls per physician per day may be claimed in the physician's office.
    Category:V Visit
    Base rate:$60.22

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 16For Each Call Pay Base At100%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70

    Governing Rules:

    • 2.3.2

      Cumulative time is calculated by adding the total time spent delivering patient care as identified in the description of the HSC, over the course of the day (GR 1.19) and dividing the total time by the time units specified in the HSC to determine the appropriate number of calls. When the remainder of the time calculation equals less than half of one call, an additional call may not be claimed. Separate encounters may only be claimed when a special call for attendance has been made on the patient's behalf.

    • 15.9

      The unscheduled service benefit (modifier SURC) may be claimed for the services outlined in GRs 15.9.1 through 15.9.3.

    • 15.9.1

      selected "V" category code services:

      1. consultations, including telehealth (except those provided using store and forward videotechnology);
      2. intensive care unit visits (HSC 03.05A);
      3. psychiatric mental status determination requiring complete mental health status examination and investigation (HSC 08.11A);
      4. for complex patient, requiring complete mental status examination and investigation (HSC 08.11C);
      5. certification under the Mental Health Act (HSC 08.12A);
      6. trauma assessment, multiple trauma, severely injured patient (HSC 13.99GA);
      7. hyperbaric oxygen therapy detention time (HSC 13.99I);
      8. medical emergency detention (HSC 13.99J);
      9. management of complex labor, per 15 minutes (HSC 13.99JA);
      10. donor maintenance prior to cadaveric harvesting of organs (HSC 13.99L);
      11. examination and crisis counseling for sexual/physical abuse (HSC 13.99V);
      12. attendance at delivery (HSC 87.98E).