At a minimum, a physician must complete a limited assessment of a patient's condition requiring a history related to the presenting problems, an examination of the relevant body systems, appropriate records, and advice to the patient.
| Common terms: |
|
|---|---|
| Category: | V Visit |
| Base rate: | $14.00 |
Governing Rule 1.6 For the purposes of billing home visits, "home" includes personal residence or temporary lodging, assisted living, designated assisted living, group home, seniors' lodge, personal care home and other residences as approved, but does not include auxiliary hospitals or nursing homes.
03.03N may be claimed when a visit service is performed for the first patient in the home.
If you are visiting a patient(s) that reside in a facility that is set up in an apartment style arrangement, where there are multiple patients in individual units within the same building or complex, 03.03NA and or 03.03NB should be used.
For services provided in an individuals home, where more than one person requires a home visit service, the second patient and subsequent patients should be billed using HSC 03.03P.
If visits are performed for respite patients, the home visit code (03.03N) may be used as this would be considered temporary lodging.
If visit services are performed at a facility where a room is set up for physicians to perform visit services, the 03.03N/P codes are not billable. The appropriate visit code (03.02A, 03.03A, 03.04A) should be used with location codes OTHR on the claim.
The location code on the claim when the service is provided at the patients home is HOME. No facility number or functional centre is required, leave these fields blank.
| Type | Code | # of calls | Explicit | Action | Amount |
|---|---|---|---|---|---|
| SKLL | ANES | Replace Base | $22.07 | ||
| SKLL | ANPA | Replace Base | $35.12 | ||
| SKLL | CARD | Replace Base | $26.25 | ||
| SKLL | CLIM | Replace Base | $40.59 | ||
| SKLL | CMSP | Replace Base | $40.59 | ||
| SKLL | CRCM | Replace Base | $21.48 | ||
| SKLL | CRSG | Replace Base | $22.81 | ||
| SKLL | CTSG | Replace Base | $22.81 | ||
| SKLL | DERM | Replace Base | $23.27 | ||
| SKLL | DIRD | Replace Base | $28.59 | ||
| SKLL | E/M | Replace Base | $39.02 | ||
| SKLL | GAST | Replace Base | $14.82 | ||
| SKLL | GNSG | Replace Base | $31.88 | ||
| SKLL | GP | Replace Base | $38.76 | ||
| SKLL | HEM | Replace Base | $40.59 | ||
| SKLL | HEPA | Replace Base | $35.12 | ||
| SKLL | IDIS | Replace Base | $14.00 | ||
| SKLL | INMD | Replace Base | $40.59 | ||
| SKLL | MDBI | Replace Base | $35.12 | ||
| SKLL | MDGN | Replace Base | $61.36 | ||
| SKLL | MDMI | Replace Base | $35.12 | ||
| SKLL | MDON | Replace Base | $40.59 | ||
| SKLL | NCMD | Replace Base | $28.59 | ||
| SKLL | NEPH | Replace Base | $61.98 | ||
| SKLL | NEUR | Replace Base | $31.66 | ||
| SKLL | NPM | Replace Base | $61.36 | ||
| SKLL | NUPA | Replace Base | $35.12 | ||
| SKLL | NUSG | Replace Base | $29.45 | ||
| SKLL | OBGY | Replace Base | $22.36 | ||
| SKLL | OCMD | Replace Base | $40.59 | ||
| SKLL | OPHT | Replace Base | $25.66 | ||
| SKLL | ORTH | Replace Base | $22.85 | ||
| SKLL | OTOL | Replace Base | $22.83 | ||
| SKLL | PATH | Replace Base | $35.12 | ||
| SKLL | PDGE | Replace Base | $61.36 | ||
| SKLL | PDNR | Replace Base | $61.36 | ||
| SKLL | PDSG | Replace Base | $61.36 | ||
| SKLL | PED | Replace Base | $61.36 | ||
| SKLL | PEDC | Replace Base | $61.36 | ||
| SKLL | PEDN | Replace Base | $61.36 | ||
| SKLL | PHMD | Replace Base | $25.66 | ||
| SKLL | PLAS | Replace Base | $31.14 | ||
| SKLL | PSYC | Replace Base | $24.05 | ||
| SKLL | RHEU | Replace Base | $21.96 | ||
| SKLL | ROSP | Replace Base | $38.76 | ||
| SKLL | RSMD | Replace Base | $44.77 | ||
| SKLL | THOR | Replace Base | $20.91 | ||
| SKLL | UROL | Replace Base | $26.35 | ||
| SKLL | VSSG | Replace Base | $25.09 | ||
| CMPX | CMGP | 1 - 10 | Yes | For Each Call Increase By | $19.19 |
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.
Disclaimer: this tool has been produced by the AMA solely as a convenient reference and the official Government of Alberta statutes and regulations must be consulted for all purposes of interpreting and applying the law. © Alberta Medical Association 2024 | Privacy Policy
