Fee Navigator®

    Governing Rule: 5.2

    SPECIAL CALLBACKS TO AACC/UCC/HOSPITAL EMERGENCY/OUT-PATIENT DEPARTMENT BY NON-ROTATION DUTY PHYSICIANS

    • 5.2.1

      HSCs 03.03KA, 03.03LA, 03.03MC and 03.03MD may be claimed when a physician is specially called from home or office to a hospital emergency department, AACC or UCC to attend one patient. Maximums apply, see GR 15.11.

    • 5.2.2

      If a physician is in a hospital, AACC or UCC for any purpose and is asked to see another patient in the hospital emergency room or the same AACC or UCC, HSCs 03.03KA, 03.03LA, 03.03MC, 03.03MD do not apply. Benefits may be claimed for the applicable visit or procedure.

    • 5.2.3

      Services provided to additional patients seen during the same callback, or services over the limits specified in GR 15.11 may be claimed as:

      1. Deleted
      2. HSC 03.02A, 03.03A, 03.03AZ, 03.03B, 03.03BZ, 03.04A, 03.04AZ as appropriate, or
      3. the applicable procedure.