A620

PDF page 211 / A83

Initiation of Food Allergy Immunotherapy (FAIT)
       Initiation of Food Allergy Immunotherapy (FAIT) is an assessment service rendered by a
       specialist in Clinical Immunology where the physician spends a minimum of 30 minutes
       (consecutive or non-consecutive) in direct in-person contact with the patient, exclusive of time
       spent rendering any other separately billable intervention to the patient, for the purpose of
       establishing and initiating:
                • the FAIT treatment protocol (mono- or poly-allergen), and
                • initial therapy doses.
       The physician must be physically present on-site and immediately available to intervene for the
       duration of the treatment session, or the service is not eligible for payment.
   A620 Initiation of Food Allergy Immunotherapy ...............................        190.60
       Payment rules:
       1.No other services listed under the "Consultations and Visits" section of the Schedule are
          eligible for payment for the same patient on the same date of service as A620
          2.Provocation testing (G208 and G190) is not eligible for payment for the same patient on the
            same date of service as A620.
          3.Time used to establish the minimum time requirements for one patient cannot overlap with
            time used to establish time units or minimum time requirements for any other patient
          4.Limited to a maximum of once per patient per allergen per lifetime
          5.Limited to a maximum of once per treatment protocol whether initiating mono-allergen or
            poly-allergen therapy
          6.A620 is only eligible for payment in circumstances where a clinical history consistent with
            IgE-mediated food allergy has been supported by appropriate diagnostic evaluation,
            including skin prick testing, allergen-specific IgE testing, oral food challenge, or a
            combination thereof
          7.A written FAIT treatment protocol must be recorded in the patient’s permanent medical
            record, including the allergens involved, initial dosing schedule, and risk assessment
          8.In circumstances where the above payment rules have not been met, the service will be
            adjusted to a lesser paying fee
          Medical record requirements:
          The service is eligible for payment only if start and stop times of the service are recorded in the
          patient's permanent medical record.

Master, record 250. Record Layout PDF, page 1.

A62020260701999999990000000000000000000000000019060000000000000000000000000

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.