- Where special visit premiums are payable for the first patient seen at a location and
insured services are rendered by the physician to an additional patient seen at the same
location, the "additional patient" premiums are not payable unless the
additional patient himself/herself qualifies for a special visit.
No "additional patient" premium is payable for services rendered to
additional patients seen during visits to homes, long term care institutions, offices and
other non-professional settings while the physician is there rendering a special visit to
another patient.
No "additional patient" premium is payable for services rendered to additional
patients seen during a special visit to a hospital unless the physician has been
specifically asked by the hospital staff to see the additional patient or patients.
Patients who drop in to the office while the physician is there for reasons other than
rendering a special visit do not qualify for any of the special visit premiums.
The maximum number of special visit premiums including "additional patient"
premiums is one per patient to a maximum of ten at any one location.
Subparagraphs (j) to (n) are amended as follows:
| (j) |
Special Visits to Emergency
Department or OPD: |
|
K990 |
Daytime Special Visit (Monday to
Friday) - first patient seen |
add |
16.70 |
|
K991 |
- |
For each additional patient requiring a special
visit and seen during the same special visit, add 30% to consultation or visit - minimum
pemium |
add |
9.50 |
|
K992 |
Emergency Call with Sacrifice of
Office hours - first patient seen |
add |
33.40 |
|
K993 |
- |
For each additional patient requiring a special
visit and seen during the same special visit, add 30% to consultation or visit - minimum
premium |
add |
14.30 |
|
K994 |
Evenings (17:00h - 24:00h) and
Saturdays, Sundays, Holidays -first patient seen . |
add |
33.40 |
|
K995 |
- |
For each additional patient requiring a special
visit and seen during the same special visit, add 30% to consultation or visit - minimum
premium |
add |
14.30 |
|
K996 |
Nights (0:00h - 7:00h) - first
patient seen |
add |
50.20 |
|
K997 |
- |
For each additional patient requiring a special
visit and seen during the same special visit, add 50% to consultation or visit - minimum
premium |
add |
22.00 |
Subparagraph (o) is changed to read:
(k) Special Visit to Hospital In-patient: Use the appropriate listing above but
substitute the prefix "C" for "K" (e.g. C990 instead of K990).
Subparagraph (j) is changed to read:
(l) Special Visit to the Patient’s Home or Equivalent (regardless of how many
patients seen at the same location. No "additional patient" premium payable):
(Descriptions and fees unchanged for B990/B992/B994/B996.)
Subparagraph (p) is changed to read:
(m) Special Visit to Long-Term Care Institution (regardless of how many patients seen
at the same location. No "additional
patient" premium payable.)
W990 Daytime, Monday to
Friday............................................................................... 16.70
W992 Emergency call with sacrifice of office
hours................................................. 33.40
W994 Evenings (17:00h - 24:00h) Saturdays, Sundays, Holidays ...........................
33.40 |