Non-operative Continuing Care Surcharges Fee Items 01205, 01206 and 01207

Continuing care surcharges apply only when there are medical indications for continuous attendance by a physician to a patient or to a continuous series of patients.

Fee Item
01205 Evening (service rendered between 1800 hrs. and 2300 hrs.)
01206 Night (service rendered between 2300 hrs. and 0800 hrs.)
01207 Saturday, Sunday or Statutory Holiday (service rendered between 0800 hours and 2300 hours)
Notes:
i.
Claim must state start and end times
ii.
Where timing is continuous, submit an account for each patient, indicating "CCFPP" (continuing care from previous patient).
iii.
Not applicable to full or part-time emergency physicians or to onsite practitioners providing coverage in drop-in emergency clinics or hospital emergency rooms.

Non-operative continuing care surcharges are applicable when an out-of-office hours call-out charge is applicable or when specially called for an emergency. Non-operative continuing care surcharges apply only to those services initiated and rendered within the designated time limits. They apply to visits to a physician's office only if the office is officially closed during the designated time period.

Timing begins after the first 30 minutes for consultations, visits or anesthetic evaluations. Payment is based on one half hour of care or major portion thereof. Therefore, the first surcharge is billable after 45 minutes of continuous care.

However, when providing continuing care from a previous patient, non-operative continuing care surcharges may be billed with minor procedures requiring less than 45 minutes of care.

 

Important Information

Non-operative continuing care surcharges do not apply to time spent standing by and are based on the amount of time providing care, regardless of the number of patients attended or services provided during that time.

The non-operative continuing care surcharge is payable to general practitioners, medical specialists and surgical specialists when non-operative services are provided. Continuing care surcharges are payable to radiologists and nuclear medicine physicians only when the primary service to which the continuing care surcharges apply are payable by MSP on a fee-for-service basis.

For all physicians, the payment agency responsible for the primary service (i.e., visit, consultation, procedure, etc.) is also responsible for any additional remuneration for out-of-office hours premiums. For example, if the visit is the responsibility of WSBC or ICBC, then WSBC or ICBC is also responsible for any additional out-of-office hours premiums.

For services that begin in the designated time period of one surcharge and extend into the designated time period of the next surcharge, the applicable non-operative continuing care surcharge fee is determined by the start time of each 30-minute time period being claimed.

These items are not meant to compensate physicians for “overtime” (i.e. when service starts prior to the designated times) and may not be billed when a physician is providing services within the designated times as part of his/her scheduled shift.

Tip: For more information regarding multiple patients seen during the same special call, refer to the MSP Tutor Module "Continuing Care From Previous Patient (CCFPP)".

Disclaimer: MSP Tutor is intended to provide a guide for physicians and medical office assistants in billing claims to MSP. For definitive information on fee-for-service fee item codes and amounts, consult the current MSC Payment Schedule. If a discrepancy exists between the information contained in MSP Tutor and the MSC Payment Schedule, the information in the Payment Schedule will prevail.

 

 

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