A695

PDF page 45 / GP31

2. Detention is not eligible for payment in conjunction with diagnostic procedures, obstetrics, and
       those therapeutic procedures where the fee includes an assessment (e.g. non-IOP surgery).
    3. Detention is not eligible for payment for time spent waiting.
    4. For the purposes of calculation of time units payable for detention, the start time commences
       after the minimum time required for the assessment or consultation listed in the table has
       passed.
    5. K001 is not eligible for payment for same patient same day as A190, A191, A192 A195, A197,
       A198, A695, A795 or A895.
          Claims submission instructions:
          Claims for detention are assessed by a medical consultant on an IC basis and require the
          submission of a written explanation.

PDF page 311 / A183

Special psychiatric consultation
       Special psychiatric consultation is a consultation in which the physician provides all the
       elements of a consultation (A195) and spends a minimum of 75 minutes in direct contact with
       the patient, exclusive of time spent rendering any other separately billable intervention to the
       patient.
   A190 Special psychiatric consultation..............................................   342.25
       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.
     Geriatric psychiatric consultation
       Geriatric psychiatric consultation is payable to a psychiatrist for a patient aged 75 years or older
       and must include all the elements of A195 and a minimum of 75 minutes in direct contact with
       the patient, exclusive of time spent in discussion with caregivers or time spent rendering any
       other separately billable intervention to the patient. The consultation must be scheduled a
       minimum of 24 hours prior to the visit. The start and stop time must be recorded in the patient’s
       permanent medical record. Maximum one per patient per physician every 5 years. Geriatric
       psychiatric consultations that do not conform with the above or are delegated in a clinic
       teaching unit to an intern, resident or fellow are payable as a lesser consultation or visit.
   A795 Geriatric psychiatric consultation ............................................   342.25
     Neurodevelopmental consultation
       Neurodevelopmental consultation is payable when the physician provides all the elements of
       A195 for an adult with complex neurodevelopmental conditions e.g. autism, global
       developmental disorders etc., and must include a minimum of 90 minutes in direct contact with
       the patient and caregiver, exclusive of time spent rendering any other separately billable
       intervention to the patient. The start and stop times must be recorded in the patient’s
       permanent medical record. Maximum one per patient per physician every 5 years.
   A695 Neurodevelopmental consultation ..........................................    456.80
       Note:
       Neurodevelopmental consultations for children or adolescents or for less complex conditions
       e.g. attention deficit disorder are payable at a lesser fee.
          [Commentary:
          Unless otherwise specified in the Schedule, the calculation of time for A190, A795 and A695
          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.]

PDF page 314 / A186

CONSULTATIONS AND VISITS
PSYCHIATRY (19)
     EMERGENCY OR OUT-PATIENT DEPARTMENT (ODP)
      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 SERVICES
    See General Preamble GP40 to GP48. For emergency calls and other special visits to n-
    patients, use General Listings and Premiums when applicable - see General Preamble GP65
    to GP78.
 C895 Consultation............................................................................  297.00
 C190 Special psychiatric consultation - subject to the same
         conditions as A190 .............................................................       342.25
 C395 Limited consultation ................................................................     120.30
 C196 Repeat consultation ................................................................      120.30
 C795 Geriatric psychiatric consultation - subject to same conditions
         as A795 .............................................................................. 342.25
 C695 Neurodevelopmental consultation - subject to same conditions
         as A695 .............................................................................. 456.80
 C193 Specific assessment ...............................................................        98.70
 C194 Specific re-assessment...........................................................          75.70
   Subsequent visits
 C192 - first five weeks........................................................ per visit                        40.05
 C197 - sixth to thirteenth week inclusive (maximum 3 per patient
        per week)................................................................ per visit                       40.05
 C199 - 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
 C198 Concurrent care .......................................................... per visit                        40.05
 C982 Palliative care (see General Preamble GP50)............ per visit                                           40.05

PDF page 315 / A187

CONSULTATIONS AND VISITS
 PSYCHIATRY (19)
     NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
      Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
      Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
      convalescent care beds in hospitals and nursing homes or homes for the aged, other than
      patients in designated palliative care beds. For emergency calls and other special visits to in-
      patients, use General Listings and Premiums when applicable - see General Preamble GP65
      to GP78.
   W895 Consultation............................................................................  297.00
   W190 Special psychiatric consultation - subject to the same
           conditions as A190 ............................................................        342.25
   W795 Geriatric psychiatric consultation - subject to same conditions
           as A795 .............................................................................. 342.25
   W695 Neurodevelopmental consultation - subject to same conditions
           as A695 .............................................................................. 456.80
   W395 Limited consultation ................................................................     120.30
   W196 Repeat consultation ................................................................      120.30

PDF page 316 / A188

Acute post-discharge community psychiatric care
     Acute post-discharge community psychiatric care is a premium for a service that occurs during
     the (4) week period immediately following discharge where the patient was a hospital in-patient
     for treatment of a psychiatric condition. The premium is only applicable to K195, K196, K197 or
     K198.
 K187 Acute post-discharge community psychiatric care, to K195,
           K196, K197 or K198 ............................................. add 15%
   High risk community psychiatric care
     High risk community psychiatric care is a premium for a service that occurs during the six (6)
     month period following a suicide attempt. For the purposes of this premium, suicide attempts
     include self-harm attempts with intent to commit suicide or high lethality self-harm attempts, but
     do not include self harm attempts of low lethality with no intent to commit suicide. The premium
     is applicable to A190, A191, A192, A195, A197, A198, A695, A795, K195, K196, K197 and
     K198.
 K188 High risk community psychiatric care, to A190, A191, A192,
          A195, A197, A198, A695, A795, K195, K196, K197 or K198
           ............................................................................. add 15%
     Payment rules:
     1.K187 or K188 are both payable with K195, K196, K197 or K198 when rendered during the
       first four (4) week period following discharge where the patient was a hospital in-patient for
       treatment of a psychiatric condition and the requirements for both K187 and K188 are met.
     2.K188 is not eligible for payment in addition to K189 on the same patient same day.
 K189 Urgent community psychiatric follow-up, to A190, A195, A192,
         A198, A695 or A795 ..................................................... add 216.30
     Payment rules:
     1.K189 is only eligible for payment when the psychiatrist providing the urgent community
       psychiatric follow-up:
        a.renders a service described by A190, A195, A192, A198, A695 or A795 to an out-patient
          on an urgent basis during the four (4) week period immediately following discharge where
          the patient was a hospital in-patient for treatment of a psychiatric condition;
        b.did not provide services to the same patient during the same psychiatric hospital
          admission; and
        c.will continue appropriate care of the out-patient for a minimum of six (6) months as
          required.
     2.K189 is limited to a maximum of one per physician per patient per 12 month period.

PDF page 826 / AJ2

APPENDIX J
VIDEO ONLY
     A010A, A011A, A015A, A016A, A021A, A025A, A026A, A035A, A036A,
     A045A, A046A, A050A, A055A, A056A, A065A, A066A, A075A, A076A,
     A085A, A086A, A095A, A096A, A116A, A130A, A135A, A136A, A150A,
     A155A, A156A, A160A, A165A, A166A, A175A, A176A, A180A, A185A,
     A186A, A190A, A191A, A192A, A195A, A196A, A197A, A198A, A205A,
     A206A, A210A, A220A, A223A, A225A, A226A, A235A, A236A, A245A,
     A246A, A253A, A255A, A256A, A260A, A265A, A266A, A275A, A285A,
     A286A, A315A, A316A, A320A, A325A, A335A, A345A, A346A, A355A,
     A356A, A365A, A375A, A385A, A395A, A400A, A405A, A415A, A416A,
     A425A, A435A, A445A, A446A, A460A, A465A, A466A, A470A, A475A,
     A476A, A485A, A486A, A515A, A525A, A545A, A565A, A575A, A580A,
     A586A, A590A, A595A, A600A, A605A, A606A, A615A, A616A, A625A,
     A626A, A635A, A636A, A645A, A646A, A655A, A662A, A665A, A667A,
     A675A, A680A, A682A, A695A, A710A, A715A, A720A, A725A, A726A,
     A735A, A745A, A770A, A775A, A795A, A800A, A801A, A802A, A814A,
     A817A, A818A, A835A, A845A, A865A, A906A, A913A, A914A, A915A,
     A925A, A935A, A945A, C010A, C013A, C014A, C015A, C016A,
     C020A, C023A, C024A, C025A, C026A, C033A, C034A, C035A, C036A,
     C043A, C044A, C045A, C046A, C051A, C053A, C054A, C055A, C063A,
     C064A, C065A, C066A, C071A, C073A, C074A, C075A, C076A, C083A,
     C084A, C085A, C086A, C093A, C094A, C095A, C096A, C111A, C113A,
     C114A, C116A, C130A, C131A, C133A, C134A, C135A, C136A, C150A,
     C151A, C153A, C154A, C155A, C156A, C160A, C161A, C163A, C164A,
     C165A, C166A, C173A, C174A, C175A, C176A, C180A, C181A, C183A,
     C184A, C185A, C186A, C190A, C193A, C194A, C196A, C203A, C204A,
     C205A, C206A, C210A, C220A, C223A, C225A, C226A, C233A, C234A,
     C235A, C236A, C243A, C244A, C245A, C246A, C255A, C260A, C263A,
     C264A, C265A, C266A, C270A, C275A, C283A, C285A, C286A, C311A,
     C313A, C314A, C315A, C316A, C320A, C325A, C335A, C341A, C343A,
     C344A, C345A, C346A, C353A, C354A, C355A, C356A, C365A, C375A,
     C385A, C395A, C411A, C413A, C414A, C415A, C416A, C425A, C435A,
     C441A, C443A, C444A, C445A, C446A, C460A, C461A, C463A, C464A,
     C465A, C466A, C470A, C471A, C473A, C474A, C475A, C476A, C480A,
     C481A, C483A, C484A, C485A, C486A, C510A, C511A, C515A, C545A,
     C565A, C570A, C575A, C580A, C585A, C586A, C590A, C595A, C600A,
     C601A, C603A, C604A, C605A, C606A, C611A, C613A, C614A, C615A,
     C616A, C623A, C624A, C625A, C626A, C635A, C643A, C644A, C645A,
     C646A, C655A, C661A, C662A, C665A, C667A, C675A, C680A, C682A,
     C695A, C720A, C721A, C723A, C724A, C725A, C726A, C710A, C713A,
     C715A, C735A, C745A, C760A, C770A, C775A, C795A, C845A, C865A,
     C895A, C915A, C925A, C935A, C945A, K630A, W025A, W026A,
     W075A, W076A, W130A, W150A, W155A, W156A, W165A, W185A,
     W190A, W196A, W235A, W236A, W275A, W310A, W355A, W356A,
     W375A, W395A, W425A, W435A, W465A, W466A, W510A, W511A,
     W515A, W516A, W535A, W720A, W725A, W726A, W770A, W775A,
     W795A, W895A, W925A

Master, record 275. Record Layout PDF, page 1.

A69520260401999999990000000000000000000000000045680000000000000000000000000

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.