If you're a psychiatrist in Alberta, choosing the right AHCIP fee codes and ensuring you're paid fully for your work can be challenging. To make it easier, we've put together this handy guide of key psychiatry billing codes.
Easier still, download our printable AHCIP Psychiatry Codes Billing Cheat Sheet for quick code lookup when you're submitting claims.
Visits
| Service Code | PSYC Base Rate | Calls | Description | Modifiers |
|---|---|---|---|---|
| 03.01AA | $0.00 | After hours time premium | TDES - Increase by $22.91 per call (1-60 calls) TEV - Increase by $22.91 per call (1-20 calls) TNTA - Increase by $45.77 per call (1-28 calls) TNTP - Increase by $45.77 per call (1-8 calls) TST - Increase by $45.77 per call (1-60 calls) TWK - Increase by $22.91 per call (1-60 calls) | |
| 03.03AR | $50.28 | Urgent or priority attendance on hospital inpatient or long term care inpatient, at request of facility staff when physician is already on site. | COINPT - Increase base by $40.61 | |
| 03.04C | $91.72 | Hospital admission | CMXC30 – Increase base by $31.59 HAEV - Increase base by $44.09 HAEVWK- Increase base by $44.09 HANTAM - Increase base by $151.04 HANTPM - Increase base by $151.04 | |
| 08.11A | $167.77 | 1-11 | Requiring complete mental status examination and investigation, first full 30 minutes or major portion thereof for the first call when only one call is claimed | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.11B | $50.33 | 1-12 | Evidence from a psychiatrist at a Review Panel on behalf of a specific patient, as required under section 37(3) of the Mental Health Act, per 15 minutes or portion thereof | TELES - Increase base to 120% |
| 08.11C | $187.90 | 1-11 | For complex patient, requiring complete mental status examination and investigation, first full 30 minutes or major portion thereof for the first call when only one call is claimed | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.12A | $58.93 | Certification under the Mental Health Act | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 | |
| 08.19A | $189.58 | 1-11 | Formal major psychiatric consultation, first full 30 minutes or major portion thereof for the first call when only one call is claimed - in office. | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.19AA | $189.58 | 1-11 | Formal major psychiatric consultation for a patient referred by a registered: occupational therapist, psychologist, community based psychiatric nurse, social worker or speech language pathologist, first full 30 minutes or major portion thereof for the first call when only one call is claimed | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.19AZ | $189.58 | 1-11 | Formal major psychiatric consultation, first full 30 minutes or major portion thereof for the first call when only one call is claimed - out of office. | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.19B | $53.13 | 1-12 | Minor psychiatric consultation, full 15 minutes or major portion thereof for the first call when only one call is claimed | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.19C | $150.44 | 1-6 | Repeat psychiatric consultation, per full 30 minutes or major portion thereof for the first call when only one call is claimed | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 TELES - Increase base to 120% |
| 08.19GA | $61.46 | 1-12 | Direct contact with a 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 - in office. | TELES - Increase base to 120% |
| 08.19GB | $68.83 | 1-12 | Direct contact 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 | TELES - Increase base to 120% |
| 08.19GZ | $61.46 | 1-12 | Direct contact with an individual patient for psychiatric treatment (including medical psychotherapy and medication prescription), psychiatric reassessment, patient education and/or psychiatric counselling, per 15 minutes or major portion thereof - out of office. | TELES - Increase base to 120% |
| 08.19L | $61.52 | 1-12 | Issuance, development and documentation of a Community Treatment Order (CTO) as defined by the Mental Health Act including all activities and services that are directly related to the CTO initiation and development, per full 15 minutes | |
| 08.19M | $61.52 | 1-12 | Second physician involved in the issuance, development and documentation of a CTO, per full 15 minutes | |
| 08.19N | $61.52 | 1-12 | Renewal, amendments, cancellation or expiry of a CTO as well as necessary work involved in the completion of an apprehension order, examination on apprehension, written statement or non-compliance report, per full 15 minutes | |
| 08.38 | $87.80 | Other electroconvulsive therapy (ECT), per treatment | EV - Increase by $48.94 NTAM - Increase by $117.41 NTPM - Increase by $117.41 WK - Increase by $48.94 | |
| 08.45 | $213.07 | 1-10 | Assessment or therapy of a family, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed - in office. | TELES - Increase base to 120% |
| 08.45A | $205.24 | 1-10 | Complex assessment or therapy of a family, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed | TELES - Increase base to 120% |
| 08.45Z | $213.07 | 1-10 | Assessment or therapy of a family, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed- out of office. | TELES - Increase base to 120% |
Group Visits
| Service Code | PSYC Base Rate | Calls | Description | Modifiers |
|---|---|---|---|---|
| 08.44C | $82.21 | 1-32 | Group psychotherapy, complex group, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed | NBPG – divide rate by the number of people in the group TELES - Increase base to 120% |
| 08.44D | $82.21 | 1-32 | Second and subsequent physician attendance at complex group psychotherapy, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed | NBPG – divide rate by the number of people in the group TELES - Increase base to 120% |
Virtual Group Visits
| Service Code | PSYC Base Rate | Calls | Description | Modifiers |
|---|---|---|---|---|
| 08.44CV | $82.21 | 1-32 | Group psychotherapy via telephone or secure videoconference, complex group, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed | NBPG – divide rate by the number of people in the group |
| 08.44DV | $82.21 | 1-32 | Second and subsequent physician attendance at complex group psychotherapy via telephone or secure videoconference, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed. | NBPG – divide rate by the number of people in the group |
Professional Conferences
| Service Code | PSYC Base rate | Calls | Description | Modifiers |
|---|---|---|---|---|
| 03.05Y | $104.16 | 1-6 | Formal, scheduled, professional interview, case conference with other physicians and/or direct therapeutic supervision of allied health professionals, educational or other community agencies on behalf of a specific patient, provided by the physician most responsible for the patient's care. | TELES - Increase base to 120% |
| 08.19F | $46.42 | 1-8 | Formal, scheduled, professional conference related to the care and treatment of a psychiatric patient with other physician(s), and/or direct therapeutic supervision of, allied health professionals, educational, correctional and other community agencies on behalf of a specific patient, provided by the physician most responsible for the patient's care, per 15 minutes or major portion thereof | TELES - Increase base to 120% |
| 08.19H | $46.42 | 1-8 | Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of a psychiatric patient, on behalf of a specific patient, per 15 minutes or major portion thereof | TELES - Increase base to 120% |
| 08.19J | $28.52 | Formal, scheduled, professional conference related to the care and treatment of multiple psychiatric patients with other physician(s), allied health professionals, educational, correctional and other community agencies on behalf of a specific patient, provided by the physician most responsible for the patient's care | TELES - Increase base to 120% | |
| 08.19K | $22.93 | Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of multiple psychiatric patients, when discussion occurs on behalf of a specific patient | TELES - Increase base to 120% |
Family Conferences and Interviews
| Service Code | PSYC Base Rate | Calls | Description | Modifiers |
|---|---|---|---|---|
| 03.05JB | $54.97 | 1-12 | Formal, scheduled family conference relating to a specific patient, per 15 minutes or major portion thereof | TELES - Increase base to 120% |
| 03.05JC | $44.92 | 1-12 | Family conference relating to acute care facility in-patient or registered emergency or out-patient, or auxiliary hospital, nursing home patient, AACC or UCC patient, per 15 minutes or major portion thereof | TELES - Increase base to 120% |
| 03.05JQ | $51.71 | Family conference with relative(s) via telephone in connection with the management of a patient with a psychiatric disorder | ||
| 08.19D | $55.92 | 1-8 | Professional interview with relative(s) in connection with the management of a patient with a psychiatric disorder, but without the patient being present during the interview, per 15 minutes or major portion thereof | TELES - Increase base to 120% |
Virtual Care and E-Consultations
| Service Code | PSYC Base Rate | Calls | Description |
|---|---|---|---|
| 03.01O | $68.99 | Physician or Nurse Practitioner to Physician secure E-Consultation, consultant | |
| 03.01R | $35.53 | Physician to Physician secure E-Consultation, referring physician | |
| 03.01S | $20.00 | Physician to patient secure electronic communication | |
| 03.01T | $20.00 | Physician to patient secure videoconference | |
| 03.05JR | $20.00 | Physician telephone call directly to patient, to discuss patient management/diagnostic test results | |
| 08.19CV | $61.46 | 1-12 | Telephone or secure videoconference with a 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 |
| 08.19CX | $189.58 | 1-11 | Formal major psychiatric consultation via telephone or secure videoconference, first full 30 minutes or major portion thereof for the first call when only one call is claimed |
| 08.19GV | $68.83 | 1-12 | 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 |
| 08.45AV | $205.24 | 1-10 | Complex assessment or therapy of a family via telephone or secure videoconference, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed |
| 08.45V | $213.07 | 1-10 | Assessment or therapy of a family via telephone or secure videoconference, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed. |
Physician Telephone or Videoconference Consultation
| Service Code | PSYC Base Rate | Description |
|---|---|---|
| 03.01LG | $35.20 | Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, weekdays 0700 to 1700 hours |
| 03.01LH | $38.55 | Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours |
| 03.01LI | $41.90 | Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, any day 2200 to 0700 hours |
| 03.01LJ | $78.12 | Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, weekdays 0700 to 1700 hours |
| 03.01LK | $115.65 | Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours |
| 03.01LL | $136.49 | Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, any day 2200 to 0700 hours |
Patient Care Advice
| Service Code | PSYC Base Rate | Description |
|---|---|---|
| 03.01AD | $20.00 | Advice to a patient or their agent (agent as defined in the Personal Directives Act) via telephone, secure email or videoconference |
| 03.01B | $28.52 | Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel weekdays 0700 to 1700 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program. |
| 03.01BA | $30.20 | Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program. |
| 03.01BB | $35.23 | Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel any day 2200 to 0700 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program. |
| 03.01NG | $18.44 | Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse weekdays 0700 to 1700 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient |
| 03.01NH | $21.79 | Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse weekdays 1700 to 2200 hours, weekends and statutory holidays, 0700 to 2200 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient |
| 03.01NI | $25.14 | Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse any day 2200 to 0700 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient |
| 03.01NM | $18.44 | Patient care advice to a pharmacist provided via telephone or other telecommunication methods in relation to the care and treatment of a patient |
Want More Psychiatry Billing Guidance?
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This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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