C317

PDF page 306 / A178

CONSULTATIONS AND VISITS
PHYSICAL MEDICINE & REHABILITATION (31)
     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.
 C315 Consultation............................................................................ 233.65
 C425 Comprehensive physical medicine and rehabilitation
          consultation – subject to the same conditions as A425......                          342.25
 C515 Limited consultation ................................................................    106.60
 C316 Repeat consultation ................................................................     106.60
 C313 Medical specific assessment ..................................................            86.40
 C314 Medical specific re-assessment..............................................              75.90
 C311 Complex medical specific re-assessment...............................                     82.75
 C510 Complex neuromuscular assessment - subject to the same
          conditions as A510 .............................................................     104.85
 C511 Complex physiatry assessment - subject to the same
          conditions as A511 .............................................................     114.80
   Subsequent visits
 C312 - first five weeks........................................................ per visit                        40.05
 C317 - sixth to thirteenth week inclusive (maximum 3 per patient
        per week)................................................................ per visit                       40.05
 C319 - 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
 C318 Concurrent care .......................................................... per visit                        40.05
 C982 Palliative care (see General Preamble GP50)............ per visit                                           40.05

PDF page 308 / A180

CONSULTATIONS AND VISITS
      PHYSICAL MEDICINE & REHABILITATION (31)
                 Team management in a Rehabilitation Unit
                  Team management in a Rehabilitation Unit active in-patient rehabilitation management from
                  the initiation of rehabilitation care as it applies to fee codes H312, H317 and H319 means when
                  this service is rendered by one physiatrist even if part of the service is rendered in an active
                  treatment hospital and part is rendered in a rehabilitation unit, the weekly and monthly
                  limitations under the following fee codes apply to the total rehabilitation care rendered. In other
                  words, it is not possible to claim the maximum fees allowed under C312, C317 and C319 and
                  then start claiming de novo under H312, H317 and H319 under the above circumstances.
               H312 - first twelve weeks ................................................... per visit        50.15
               H317 - from thirteenth to twenty-sixth week (maximum 3 per patient
                        per week)................................................................ per visit   50.15
               H319 - twenty-seventh week onwards (maximum 6 per patient per
                        month) .................................................................... per visit 50.15
                 Rehabilitation counselling
                  Rehabilitation counselling one or more persons. Unit means ½ hour or major part thereof - see
                  General Preamble GP7, GP55 for definitions and time-keeping requirements.
               H313 Rehabilitation counselling ........................................... per unit 84.20
                 Physiatric management
                   Physiatric management is the service rendered by physiatrists for regulation, management and
                   supervision of the active, regular, and ongoing treatment of a patient in a rehabilitation
                   department by physical or other (e.g. occupational, speech) therapists. The service also
                   includes making arrangements for any related assessments, procedures or therapy and
                   making arrangements for follow-up care as required.
               K313 Physiatric management .......................................................... 8.10
                   Payment rules:
                   1.Physiatric management is not eligible for payment if any other service is rendered by the
                     same physician on the same day to the same patient.
                                          2.This service is only eligible for payment on days when rehabilitation services are provided to
                                            patients seen previously by the physiatrist for consultation or assessment.

Master, record 618. Record Layout PDF, page 1.

C31720260401999999990000000000000000000000000004005000000000000000000000000

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.