Fee Navigator®

    Health Service Code 08.19GV

    Telephone or secure videoconference with a complex patient for psychiatric treatment (including medical psychotherapy and medication prescription), psychiatric reassessment, patient education and/or psychiatric counseling, per 15 minutes or major portion thereof

    NOTE:
    1. May only be claimed by a psychiatrist or a generalist in mental health.
    2. The patient's record must include a detailed summary of all services provided including time spent and start and stop times.
    3. Only time spent communicating with the patient and/or the parent/guardian of a patient child can be claimed as part of the service. Time spent on administrative tasks cannot be claimed.
    4. May not be claimed on the same day as a virtual visit or consultation by the same physician for the same patient.
    5. May not be claimed on the same day as an in-person visit or consultation service by the same physician for the same patient.
    6. May only be claimed when the patient meets the criteria outlined in note 7 and the score is identified in the patient's chart at least once every six months.
    7. Complex patient is defined as: a. An adult with a Global Assessment of Function (GAF) score of 40 or less. b. A child with a Children's Global Assessment of Function (CGAS) score of 41 or less.
    Category:V Visit
    Base rate:$47.02

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$47.02
    SKLLPSYCReplace Base$64.80
    SESUSESU1 - 32For Each Call Pay Base At100%
    CALLM151 - 12For Each Call Pay Base At100%

    Governing Rules:

    No Governing Rules.