Governing Rules:

• 6.6.2

  If a procedure designated "+" is performed in a physician's office, both the procedural benefit and the appropriate office visit benefit for that day may be claimed, but if a consultation benefit pursuant to GR 6.6.4 has been claimed, a visit benefit will not be payable for the day on which the procedure is performed.

• 6.6.3

  If a procedure designated "+" is performed in a place other than a physician's office, either a procedural benefit or a visit benefit, but not both, may be claimed for that day.

• 6.6.4

  If a procedure designated "+" and a consultation are provided on the same day, both the procedural benefit and the appropriate consultation benefit are payable.

• 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.