This service may only be
claimed by Psychiatrists and consists of unscheduled evaluation and management of
a patient with an acute mental health crisis. This fee code can only be claimed when a
patient is assessed in a hospital emergency department on an urgent basis.
DEFINITIONS/REQUIREMENTS OF VISIT CODES OTHER THAN
CONSULTATIONS
Unless otherwise stated, the term visit used in this Schedule means each separate and
distinct time a physician provides services to a patient in a given day. To be recorded
as separate visits, multiple services provided to a patient may not be initiated by the
physician, or may not be a continuation of a service which began earlier in the day. An
example of continuation of services is the time spent with a patient to review x-ray or
laboratory results ordered during an examination of the patient earlier in the day. If the
patient initiates the second and subsequent visit(s) or the physician is requested to
attend the patient by hospital or nursing home staff based on medical necessity,
additional visits and/or premiums may be claimed.
Add-on Fee for Scheduled After Hours General Practice Clinics
(a) Fee code 139 can be billed by General Practitioners who see patients in regular
scheduled clinics between the hours of 6:00 p.m. and midnight on weekdays, on
weekends, or on MCP Statutory Holidays. It can be billed in addition to General
Practice fee codes 101, 111, 112, 114, 118, 121, 122, 123, 124, 126, 131, 132, and
136. It is not payable with any other code;
(b) Fee code 139 is not payable when special visit codes either 50, 52 or 53 are claimed;
(c) To document this code for services rendered on weekdays between 6:00 p.m. and
midnight, the start time for the patient encounter must be entered on the record of
service for the associated visit code. For weekends and MCP Statutory Holidays, the
date of service is sufficient.
