NOTE: 1. May be claimed on the date of transfer by the receiving physician when assuming responsibility for care of an intensive care patient. 2. Only one transfer may be claimed per patient, per calendar week, regardless of whether the same or different physician provides the service. 3. The physician from whom the care is being transferred may claim a hospital visit or intensive care visit, as appropriate, on the day of transfer. 4. May not be claimed for weekend coverage or within 24 hours of admission to hospital. 5. 03.05A may be claimed by the receiving physician after 30 minutes of time related to care of the patient has been spent.

NOTE: 1. Trauma care visit includes daily visit, review of blood work, laboratory and x-ray results, and management of care with co-ordination of required consultations. The first day of trauma care may be claimed using HSC 13.99GA. 2. May only be claimed by the co-ordinating surgical specialist. 3. May not be claimed in addition to a major surgical procedure performed by the same (trauma) physician. 4. May only be claimed for referred cases. 5. A maximum of 6 HSC 03.05B (one for each hospital day) may be claimed for care delivered following the trauma admission (HSC 13.99GA). 6. Daily hospital visits for those trauma patients requiring care past seven days, should be claimed using HSC 03.03D beginning on the eighth day and onwards. 7. May be claimed in addition to care provided by intensivists.

NOTE: Refer to the note following 03.05ER.

NOTE: Refer to the note following HSC 03.05ER.

NOTE: HSCs 03.05CR, 03.05DR and 03.05ER may only be claimed by physicians who are on-site and working a scheduled rotation duty shift in an emergency department, or are providing first call coverage in an emergency department with greater than 25,000 visits per year.

NOTE: Refer to the notes following HSC 03.05HR.

NOTE: Refer to the notes following HSC 03.05HR.

NOTE: HSCs 03.05FR, 03.05GR and 03.05HR may only be claimed by physicians who are on-site and working in an AACC or UCC.

NOTE: Refer to the notes following HSC 03.05FB.

NOTE: Refer to the notes following HSC 03.05FB.

NOTE: 1. HSCs 03.05F, 03.05FA and 03.05FB may not be claimed on the same shift by the physician who provided the initial assessment. 2. HSCs 03.05F, 03.05FA and 03.05FB may only be claimed once per patient per emergency room shift. 3. HSCs 03.05F, 03.05FA and 03.05FB may only be claimed by physicians on rotation duty in an emergency department, or providing first call coverage in an emergency department with greater than 25,000 visits per year. 4. Should the patient remain in the emergency room awaiting an in-patient bed after admission to hospital, HSCs 03.05F, 03.05FA and 03.05FB may not be claimed by the emergency room physician.

NOTE: Refer to the notes following HSC 03.05FE.

NOTE: Refer to the notes following HSC 03.05FE.

NOTE: 1. HSCs 03.05FC, 03.05FD and 03.05FE may not be claimed on the same shift by the physician who provided the initial assessment. 2. HSCs 03.05FC, 03.05FD and 03.05FE may only be claimed once per patient per shift. 3. HSCs 03.05FC, 03.05FD and 03.05FE may only be claimed by physicians on rotation duty in an AACC or UCC.

NOTE: Refer to the notes following HSC 03.05FH.

NOTE: Refer to the notes following HSC 03.05FH.

NOTE: 1. May only be claimed by the same physician who provided the initial assessment when a second call for attendance has been made by staff or another physician. 2. May be claimed by a different physician who is taking over care of the patient.

NOTE: May only be claimed when no other visit service has been provided on that day, regardless of physician.

NOTE: 1. May be claimed when the conference involves the physician and one or more allied health professionals. 2. May be claimed by more than one physician where circumstances warrant (text will be required). 3. May be claimed to a maximum of 12 calls or 3 hours per year (April 1 to March 31), per patient, per physician.

NOTE: Refer to the notes following HSC 03.05JF.

NOTE: 1. HSCs 03.05JE and 03.05JF may only be claimed by physicians present during and directly involved in the medication review. 2. HSCs 03.05JE and 03.05JF are to be claimed using the Personal Health Number of the patient, naming the personnel, agencies or organizations involved. 3. Each physician involved in a patient conference may claim for patient services using HSCs 03.05JE or 03.05JF per patient, to a maximum of 6 patients in a 30-minute period. 4. HSC 03.05JF may be claimed when the physician most responsible for the patient's care has submitted a claim under HSC 03.05JE.

NOTE: 1. May not be claimed at the same encounter as a visit. 2. May be claimed to a maximum of 12 calls or 3 hours per year (April 1 to March 31), per patient, per physician.

NOTE: 1. This service is to be claimed using the Personal Health Number (PHN) of the parent or legal guardian. 2. May only be claimed for children 18 years of age and under at the time of death. 3. Supporting information identifying the name and PHN of the child must be submitted. 4. May only be claimed by pediatrics (including subspecialties) or by medical genetics.

NOTE: 1. Intended specifically for patients whose condition warrants periodic family conferences. 2. May be claimed to a maximum of 12 calls or 3 hours per year (April 1 to March 31), per patient, per physician.

NOTE: 1. This service is to be claimed using the Personal Health Number of the patient. 2. May be claimed in situations where: a) location or mobility factors of family members at the time of the call preclude in person meetings. b) communication about a patient's condition or to gather collateral information that is relative to patient management and care activities. 3. May not be claimed for: a) relaying results for lab or diagnostics. b) arranging follow up care. 4. Documentation of the communication to be maintained in the patient record. 5. May be claimed in the pre and post-operative periods.

NOTE: 1. Intended specifically for patients whose condition warrants periodic family conferences or for patients who are unable to properly communicate with their physician (e.g., situations where there is a language barrier, unconscious patient, etc.). 2. This service is to be claimed using the Personal Health Number of the patient. 3. May be claimed in situations where: a) location or mobility factors of family members at the time of the call preclude in person meetings. b) timely communication with family members is essential to patient care or organ/tissue transfer collection, and c) communication about a patient's condition or to gather collateral information that is relative to patient management and care activities. 4. May not be claimed for: a) relaying results for lab or diagnostics. b) arranging follow up care. 5. Documentation of the communication to be maintained in the patient record. 6. May be claimed in addition to visits or other services provided on the same day, by the same physician. 7. May only be claimed when the physician provides the service.

NOTE: 1. This service is to be claimed using the Personal Health Number of the patient. 2. May be claimed in situations where: a) the patient's family is to be notified of a mental health crisis. b) location or mobility factors of family members at the time of the call preclude in person meetings. c) timely communication with family members is essential to patient care and/or management. d) communication about a patient's condition is required to gather collateral information that is relative to the patient management and care activities. 3. May not be claimed for: a) relaying results for lab or diagnostics. b) gathering information that is in relation to the development of a Community Treatment Order (CTO). c) arranging for follow-up care. 4. Documentation of the communication and relationship of family member to the patient must be recorded in the patient record. 5. May be claimed in addition to visits or other services provided on the same day, by the same physician.

NOTE: 1. A maximum of 14 telephone calls per physician, per calendar week may be claimed. 2. May not be claimed for management of patient's anticoagulant therapy (billable under HSC 03.01N). 3. May only be claimed when communication is provided by the physician. 4. Documentation of the communication to be recorded in the patient record. 5. May be claimed in addition to visits or other services provided on the same day, by the same physician. 6. Neither HSCs 03.01S or 03.01T are payable if HSC 03.05JR is claimed in the same calendar week by the same physician for the same patient.

NOTE: May only be claimed by physiatrists.

NOTE: This service is to be claimed in the name of the patient by the physician most responsible for the patient.

NOTE: This service is to be claimed in the name of the patient.

NOTE: 1. This service is to be claimed by the physician most responsible for the patient where the physician spends a minimum of 30 minutes with medical and/or para-medical personnel regarding the management of chronic pain. 2. In those situations where the physician is not part of a comprehensive, coordinated, interdisciplinary chronic pain program, the patient must have been initially assessed at an interdisciplinary chronic pain program, the name of which must be identified in the patient's chart when the patient is referred back to the home community for ongoing treatment.

NOTE: 1. This service is to be claimed in the name of the patient. 2. In those situations where the physician is not part of a comprehensive, coordinated, interdisciplinary chronic pain program, the patient must have been initially assessed at an interdisciplinary chronic pain program, the name of which must be identified in the patient's chart when the patient is referred back to the home community for ongoing treatment.

NOTE: 1. This service is to be claimed in the name of the patient. 2. In those situations where the physician is not part of a comprehensive, coordinated, interdisciplinary chronic pain program, the patient must have been initially assessed at an interdisciplinary chronic pain program, the name of which must be identified in the patient's chart when the patient is referred back to the home community for ongoing treatment.

NOTE: Refer to the notes following HSC 03.05JN.

NOTE: 1. HSC 03.05JM may only be claimed by Physiatry. 2. HSC 03.05JN may be claimed by any physician that is participating in the conference. 3. HSCs 03.05JM and 03.05JN are to be claimed using the Personal Health Number of the patient. 4. HSC 03.05JN may be claimed when the physician most responsible for the patient's care has submitted a claim under 03.05JM.

NOTE: 1. May not be claimed unless the physician has seen the patient and been directly involved in the patient's care. 2. May only be claimed by: - pediatricians (including subspecialties) for patients 18 years of age and under - medical geneticists and psychiatrists (no age restriction) when a minimum of 30 minutes has been spent. 3. A maximum benefit of 3 hours applies per session. 4. A maximum benefit of 6 hours per patient, per physician, per benefit year, applies. 5. This service is to be claimed using the Personal Health Number of the patient. 6. HSC 03.03D may be claimed on the same day.

NOTE: May only be claimed when the physician most responsible for the patient's care has submitted a claim under HSC 03.05Y.

NOTE: 1. May only be claimed by: - pediatricians (including subspecialties) for patients 18 years of age and under; - medical geneticists (no age restriction). 2. May only be claimed: - when the communication is initiated by the allied health, educational or community agency; - for services related to school difficulties, learning disorders, behavioural problems, psychiatric disorders, developmental disorders, major chronic disease, pre-transplant donor/recipient assessment, multiple handicap disorders, child abuse or neglect. 3. May be claimed: - for communication provided in person, by telephone or other telecommunication methods; - in addition to visits or other services provided on the same day by the same physician. 4. A maximum benefit of 60 minutes or 12 calls per physician, per week, applies. 5. This service is to be claimed using the Personal Health Number of the patient. 6. Documentation of the communication must be recorded in the patient record.

NOTE: 1. May only be claimed by: pediatricians (including subspecialties) for patients 18 years of age and under, or by medical geneticists (no age restriction). 2. A maximum of two conferences may be claimed per patient, per physician, per calendar year. 3. May not be claimed on the same day as a visit.

NOTE: May not be claimed in addition to a visit at the same encounter.

NOTE: May be claimed to a maximum of four visits per patient hospitalization.

NOTE: A maximum of one visit per week, per physician, may be claimed.

NOTE: 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.

NOTE: In those situations where the physician is not part of a comprehensive, coordinated, interdisciplinary chronic pain program, the patient must have been initially assessed at an interdisciplinary chronic pain program, the name of which must be identified in the patient's chart when the patient is referred back to the home community for ongoing treatment.

NOTE: Refer to notes following 03.05R for further information.

NOTE: Refer to notes following 03.05R for further information.

NOTE: Refer to notes following 03.05R.

NOTE: Refer to notes following 03.05R.

NOTE: 1. May only be claimed when a special call for attendance is made on the patient's behalf. 2. Benefits are payable based on the time at which the encounter commences. 3. The physician responds to such a call from outside the hospital, on an unscheduled basis. 4. The patient is attended on a priority basis. 5. There is direct attendance by the physician. 6. Second or subsequent patients seen during the same callback are not eligible for benefits under HSCs 03.05N, 03.05P, 03.05QA, 03.05QB or 03.05R but may be claimed using HSC 03.03AR. 7. May not be claimed in association with any HSC except HSC 03.01AA or 03.03DF. Refer to GR 15.8. 8. Special callback benefits (03.05N, 03.05P, 03.05QA, 03.05QB or 03.05R) should be claimed in addition to HSC 03.03DF.