General practice 13028 - Community based gp: supportive care hosp visit

General Info

Billing Amount: $35.79


Referring physician may charge one hospital visit for each day hospitalized during the first ten days of hospitalization and thereafter one visit for every seven days hospitalized {Preamble D. 4. 7.}.

Essential non-emergent additional visits to a hospitalized patient by the physician providing supportive care for diagnosis unrelated to the admission diagnosis, during one day are to be billed under fee item 00108 or 13008. The claim must include the time of each visit and a statement of need included in a note record.

For weekday, daytime emergency visit, see fee item 00112. Fee items 12200, 13200, 15200, 16200, 17200, 18200 may be billed for additional evening, night time, or weekend emergent hospital visits same day, same patient when the attending physician or replacement physician is specially called back as the patient’s condition has changed, requiring the physician’s attendance or due to a condition unrelated to the hospitalization. If physician is on-site and called for emergent care, fee items 00113, 00105 or 00123 are billable. The claim must include the time of service and an explanation for the visit included in the note record.

Active privileges signify the physician has the authority to write orders, whereas courtesy/associate privileges permit the GP to write progress notes in charts, but not orders.

Pre-Amble References:

Please reference the billing pre-amble for these relevant interpretations of this billing code:

See Pre-Amble Notes