10001 - Urgent specialist advice (phone or in person)

General Info

Billing Amount: $60.00


The purpose of this fee is for the specialist to provide urgent real-time advice when the intent of communication is to replace the need for the specialist to see the patient in person. The consulting specialist is responsible for ensuring that an appropriate communication modality is used to meet the medical needs of the patient.


i)Payable to Specialist Physicians for urgent real-time advice (including telephone, video technology or face to face communication) regarding assessment and management of a patient but without the consulting physician seeing the patient.
ii)Conversation must take place within two hours of the initiating physician’s request. Not payable for written communication (i.e. fax, letter, e-mail).
iii)Includes discussion of pertinent family/patient history, history of presenting complaint, and discussion of the patient's condition and management after reviewing laboratory and other data where indicated.
iv)An adequate medical record/chart entry, including time of initiating request and time of response as well as advice given and to who, is required.
v) Include the practitioner number of the physician requesting advice in the "referred by" field when submitting claim.
vi)Limited to one claim per patient per physician per day.
vii)Not payable to physician initiating communication.
viii)Not payable in addition to another service on the same day for the same patient by same practitioner.
ix)The specialist is responsible for the confidentiality and security of all records and transmissions related to video technology.
x) Not payable if there is a paid visit/service for the same condition by the same practitioner in the previous 180 days

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