Fee Navigator®

    Health Service Code 87.98D

    Multiple birth, vaginal delivery (for each additional newborn)


    May be claimed at 100% in addition to delivery benefits regardless of who performs the delivery.

    Category:M Minor Procedure
    Base rate:$156.55

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$62.18
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70

    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.

    • 8.1.4

      The delivery benefit includes payment to the attending physician for procedures such as surgical induction, episiotomy, repair of episiotomy or non-extensive lacerations (first or second degree as defined below), and ordinary immediate care of the newborn.

      First degree is defined as a superficial laceration of the vaginal mucosa or perineal body which does not require suturing.

      Second degree is defined as a laceration involving the vaginal mucosa and/or perineal skin and deeper subcutaneous tissue and requiring suturing.

      Third degree is defined as an extension of the laceration which involves any part of the capsule or anal sphincter muscle or deep vaginal sidewall laceration.

      Fourth degree is defined as extensive including involvement of the rectal mucosa.

    • 8.1.5

      When a delivery occurs within 24 hours of admission, the delivery benefit includes the hospital admission (HSC 03.04C) or hospital visit (03.03D). Post-partum hospital visits, by the same or different physician, for the period of one week after the delivery, and ordinary immediate care of the newborn are also included. When there is a life threatening situation which requires neonatal resuscitation, HSC 13.99F may be claimed as well.