Criteria:
All of the following criteria must be met:
- Patient must be referred initially.
- Visit must be scheduled.
- The patient must have been previously examined by a physician at a earlier encounter.
- Specialty restrictions: CARD, CLIM, CRCM, DERM, E/M, GAST, HEM, IDIS, INMD, MDGN, MDON, NEPH, NEUR, NPM, PDGE, PDNR, PED, PEDC, PEDN, PHMD, RHEU, RSMD, VSSG.
These fee codes may not be claimed for the following:
- Transfer of care.
Additional information:
Complexity modifiers (CMXV15, CMXV20, CMXV30, CMXV35) may be claimed in addition as appropriate.
The following specialties may claim 03.03FA in addition to 03.03F and CMXV30 or CMXV20 when a follow-up visit exceeds 30 minutes:
- CARD
- E/M
- INMD
- MDGN
- NPM
- PDGE
- PDNR
- PED
- PEDC
- PEDN
- PHMD
- VSSG
Related fee codes:
03.03FA, CMXV15, CMXV20, CMXV30, CMXV35