A480

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CONSULTATIONS AND VISITS
RHEUMATOLOGY (48)
  For Services not listed, refer to Internal Medicine Section.
  GENERAL LISTINGS
A485 Consultation............................................................................              202.40
   Comprehensive rheumatology consultation
     This service is a consultation rendered by a specialist in rheumatology who provides all the
     appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of
     direct contact with the patient exclusive of time spent rendering any other separately billable
     intervention to the patient.
 A590 Comprehensive rheumatology consultation............................           342.25
     Medical record requirements:
     For A590, the start and stop times must be recorded in the patient’s permanent medical record
     or the amount payable for the service will be adjusted to a lesser paying fee.
       [Commentary:
       1.A590 must satisfy all the elements of a consultation (see page GP16).
       2.Unless otherwise specified in the Schedule, the calculation of the time for comprehensive
         rheumatology consultations excludes (1) time devoted to any other service or procedure for
         which an amount is payable in addition to the consultation and (2) non-patient-facing time
         such as such as time spent reviewing charts, imaging, or documentation, etc.]
 A595 Limited consultation ................................................................                124.50
 A486 Repeat consultation ................................................................                 125.10
 A483 Medical specific assessment ..................................................                        95.95
 A484 Medical specific re-assessment..............................................                          72.00
 A481 Complex medical specific re-assessment...............................                                 83.40
 A488 Partial assessment .................................................................                  44.75
 E078        - chronic disease assessment premium (see General
               Preamble GP25) ................................................ add 50%
   Complex rheumatology assessment
     A complex rheumatology assessment is an assessment for the ongoing management of the
     following diseases of the musculoskeletal system where the complexity of the condition
     requires the continuing management by a rheumatologist:
         a.Systemic vasculitides;
         b.Inflammatory myopathies;
         c.Polymyalgia rheumatica; or
         d.Paediatric vasculitides.
 A480 Complex rheumatology assessment.......................................     113.85
     Payment rules:
     1.A complex rheumatology assessment must include the elements of a medical specific re-
       assessment, or the amount payable will be adjusted to lesser assessment fee.
       2.This service is not eligible for payment to a physician for the initial evaluation of the patient by
         that physician.
       3.Complex rheumatology assessments are limited to 6 per patient, per physician, per 12 month
         period. Services in excess of this limit will be adjusted to a lesser assessment fee.
       4.E078 is not eligible for payment with A480.

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CONSULTATIONS AND VISITS
 RHEUMATOLOGY (48)
        EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
         Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
         the Emergency or OPD - use General Listings.
     NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
      See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
      patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
      GP78.
   C485 Consultation............................................................................ 201.95
   C590 Comprehensive rheumatology consultation - subject to the
           same conditions as A590 ...................................................           342.25
   C595 Limited consultation ................................................................    124.50
   C486 Repeat consultation ................................................................     124.50
   C483 Medical specific assessment ..................................................            95.95
   C484 Medical specific re-assessment..............................................              72.00
   C481 Complex medical specific re-assessment...............................                     83.40
   C480 Complex rheumatology assessment - subject to the same
           conditions as A480 .............................................................      112.00
     Subsequent visits
   C482 - first five weeks........................................................ per visit           40.05
   C487 - sixth to thirteenth week inclusive (maximum 3 per patient
          per week)................................................................ per visit          40.05
   C489 - after thirteenth week (maximum 6 per patient per month)
           ............................................................................... per visit   40.05
     Subsequent visits by the Most Responsible Physician (MRP)
      See General Preamble GP44 to GP45 for terms and conditions.
   C122 - day following the hospital admission assessment..............                                71.80
   C123 - second day following the hospital assessment ..................                              71.80
   C124 - day of discharge .................................................................           71.80
   C126 - day of discharge, medically complex patient (see A13 for
          terms and conditions) .........................................................              95.10
     Subsequent visits by the MRP following transfer from an Intensive Care Area
      See General Preamble GP46 for terms and conditions.
   C142 - first subsequent visit by the MRP following transfer from an
          Intensive Care Area............................................................ 71.80
   C143 - second subsequent visit by the MRP following transfer from
          an Intensive Care Area.......................................................   71.80
   C121 Additional visits due to intercurrent illness (see General
          Preamble GP43)..................................................... per visit                40.05
   C488 Concurrent care .......................................................... per visit           40.05
   C982 Palliative care (see General Preamble GP50)............ per visit                              40.05

Master, record 217. Record Layout PDF, page 1.

A48020260401999999990000000000000000000000000011385000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.