K737

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Physician on duty in an emergency department or a hospital urgent care clinic
   K736 CritiCall telephone consultation - Referring physician ............             37.05
   K737 CritiCall telephone consultation - Consultant physician..........               47.75
       [Commentary:
       Referring and consultant physicians participating in Criticall telephone consultations while on
       duty in an emergency department or a hospital urgent care clinic should submit claims using
       K736 and K737. K732 and K733 should not be claimed in these circumstances.]
          Payment rules:
          1.A maximum of 2 K732 or K736 services (any combination) are eligible for payment per
            patient, per day.
          2.A maximum of 1 K733 or K737 service is eligible for payment per physician, per patient, per
            day.
          3.A maximum of 1 E150 service is eligible for payment per physician, per patient, per day.
          4.A maximum of 3 K733 or K737 services (any combination) are eligible for payment per
            patient, per day.
          5.These services are only eligible for payment for a CritiCall telephone consultation service
            that fulfills all of the following criteria:

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CONSULTATIONS AND VISITS
 FAMILY PRACTICE & PRACTICE IN GENERAL (00)
          Claims submission instructions:
          K733 and K737 are only eligible for payment if the consultant physician includes the referring
          physician or nurse practitioner’s provider number with the claim.
          [Commentary:
          1.“Payment, other than by fee-for-service” includes compensation where the physician
            receives remuneration under a salary, primary care, stipend, APP or AFP model.
          2.In certain circumstances, more than one consultant physician may be required to participate
            in the same CritiCall telephone consultation. Each consultant physician may submit a claim
            for the teleconference subject to the established limits.
          3.Physicians who receive compensation other than by fee-for-service under this Schedule
            should consult their contract for guidance on shadow-billing.]

Master, record 3050. Record Layout PDF, page 1.

K73720260401999999990000047750000000000000000000000000000000000000000000000

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.