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    Health Service Code 13.99V

    Examination and crisis counselling for sexual/physical abuse, full 15 minutes or major portion thereof for the first call when only one call is claimed

    NOTE:
    1. A maximum of 16 calls may be claimed.
    2. Time taken for forensic evidence is not to be included in total time.
    Common terms:
    • rape kit
    Category:V Visit
    Base rate:$57.05

    AMA billing tips:

    • The completion of a rape kit at the request of police is an uninsured service and should be billed directly to the requesting detachment. Physicians are encouraged to establish a rate with the detachment, where possible, in advance of completing services. This may make more sense in rural locations where there are fewer detachments.

      The time spent completing the kit cannot be used in the calculation of the time claimed to Alberta Health for the 13.99V.

      The AMA has suggested rates for kit completion in the Guideline to Billing Uninsured Services publication. The guide is only available on the AMA website and requires physician login. The "Read More" link below will take you to the login page for the Uninsured Services Guide.

    • The total time spent performing services under 13.99V may be claimed on a cumulative basis. See GR 2.3.2 for more information about claiming for cumulative time.

    • This code is intended for those instances where a patient has been sexually assaulted and or physically abused either domestic situation or as a result of intentional/repeated abuse. This code is NOT intended for other types of physical assault.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 16For Each Call Pay Base At100%
    CALLM15To a Maximum Of$912.80
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70

    Governing Rules:

    • 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).