These fees apply to the services of being in constant or periodic attendance during a one day
period, to provide all aspects of care to patients in Neonatal Intensive Care Units designated
by the DHCS. There are three levels of care depending upon the procedures performed.
These are team fees which apply to Neonatologists/Pediatricians/Anaesthesiologists
providing complete daily care and should be claimed by the physician in charge of the
patient. The daily fee includes the initial consultation, subsequent assessments, and the
ongoing monitoring of the patient’s condition, including the following procedures as required:
(a) insertion of IVs, arterial and CVP lines,
(b) use of pressure infusion sets,
(c) endotracheal intubation and tracheobronchial toilet,
(d) insertion and maintenance of urinary catheters and nasogastric tubes,
(e) securing and interpreting the results of arterial blood gas samples, and
(f) the use of artificial ventilation.
These fees may be claimed in the post-operative period for patients receiving either Level A
or B care. Level C care cannot be claimed for post-operative infants.
Physicians not part of the daily care team, whose additional expertise is required, may bill for
each item of service performed, including Concurrent Care (fee code 51790).
When a patient’s care is transferred to a higher or lower level, the second day rate for that
level applies. However, in any one period of NICU care, the first day rate for the highest level
is payable for the date the patient transferred to that level. Only one first day rate is payable
per NICU period.
