For palliative care services provided in the patient's home, the subdivision (SUBD) modifier may only be claimed when a special call has been made on behalf of the patient and the physician responds within a 24 hour period from the time of the call. The time of the initial call as well as the time of the service must be documented in patient's record.
| Category: | V Visit |
|---|---|
| Base rate: | $53.97 |
| Type | Code | # of calls | Explicit | Action | Amount |
|---|---|---|---|---|---|
| CALL | M15 | 1 - 96 | For Each Call Pay Base At | 100% | |
| SUBD | OFEV | Yes | Increase Base By | $44.61 | |
| SUBD | OFEVWK | Yes | Increase Base By | $52.30 | |
| SUBD | OFNTAM | Yes | Increase Base By | $119.89 | |
| SUBD | OFNTPM | Yes | Increase Base By | $119.89 | |
| TELE | TELES | Yes | Increase Base To | 120% |
An "in office" service is defined as a service that is not provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "in office": 03.03A, 03.03B, 03.03F, 03.04A, 03.05I, 03.07A, 03.08A, 03.08B, 03.08I, 03.08J, 08.19A, 08.19G, 08.19GA, and 08.45.
An "out of office" service is defined as a service that is provided in the following publically funded facility types: Active Treatment Centre, Ambulatory Care Centre, Auxiliary Hospital, Health Canada Nursing Station, Community Ambulatory Care Centre, Community Mental Health Clinic, Nursing Home, Regional Contracted Practitioner Office and Subacute Auxiliary Hospitals. The following Health Service Codes are designated as "out of office": 03.03AZ, 03.03BZ, 03.03FZ, 03.04AZ 03.05IZ, 03.07AZ, 03.08AZ, 03.08BZ, 03.08IZ, 03.08JZ, 08.19AZ, 08.19GZ, and 08.45Z
Palliative Care: Defined as care given to a patient with a terminal disease such as cancer, AIDS or advanced neurologic disease. Palliative care involves active ongoing multi-disciplinary team care. Physicians involved in palliative care may claim for services provided under 03.05I, 03.05IZ, 03.05T and 03.05U as applicable.
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