Services Provided in the Emergency Room

The following three factors determine the appropriate visit fee to bill when service is provided in the emergency room:

  • If the physician is the designated emergency room physician (doctor of the day);
  • Where the physician is located when called to the emergency room; and
  • The time of day.

The following examples illustrate the correct billing for different situations:

Example 1:

Physician is the emergency physician designated by the medical staff, and is on hospital Emergency Department duty and is on-site:

What to bill:
Bill the appropriate fee item from the 01800 series in the Emergency Medicine section of the MSC Payment Schedule.


For additional information, please refer to the Section of Emergency Medicine Preamble.

Example 2:

Physician is already at the hospital when called to see a patient (age 35) in the emergency room but is not on a scheduled shift in the emergency room.

What to bill:
Bill the appropriate On-call On-site hospital visit fee if service is between 1800 and 0800 hours, or on a Saturday, Sunday or Statutory Holiday (i.e., 00113, 00105, or 00123). For weekday services between 0800 and 1800 hours, bill the appropriate out of office visit fee (e.g.: 13200).

Please refer to Out-Of-Office Hours Premiums section in the MSC Payment Schedule.

Example 3:

Physician is called from home to attend a patient in the emergency room on an urgent basis.

What to bill:
General Practice physicians should bill the appropriate out of office visit fee plus call-out charge if out-of-office hours, or the appropriate emergency visit fee (e.g.: 00112) if during a weekday (call placed between hours of 0800 and 1800 hours).

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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