Out-of-Office Hours Premiums with Delivery Fee Items 01205, 01206 and 01207

The non-operative continuing care surcharge fees (fee items 01205, 01206, 01207) apply to delivery only, not to standby time or the first stage of labour. State the continuous time spent with the patient during second or third stages of labour only.

Tip: Be sure your note record clearly states "Second Stage", "Third Stage", or "Fully Dilated" to enable the Claims Processing System to process the claim correctly.

The non-operative continuing care surcharge fees (fee items 01205, 01206, 01207) may also be billed in addition to fee item 14199 (Management of prolonged second stage of labour, per 30 minutes or major portion thereof) when applicable.

  Fee item 14199: Timing begins after the first two hours of continuous care for the second stage of labour and ends at delivery (third stage).
Fee items 01205 - 01207: Timing begins after the first 30 minutes of continuous care for the second stage of labour.

Only one emergency visit fee (e.g., fee item 00112) or call-out charge (fee items 01200, 01201, 01202) is routinely payable with delivery. Additional call-backs prior to delivery are not normally paid for routine, expected follow-ups because these services are considered included in the fee established for the delivery.

Note: If there are serious, unexpected complications that require the physician's immediate attendance (such as fetal distress) the appropriate visit(s) and/or call-out charge(s) may be billed. Provide details of the serious, unexpected complications requiring the physician's immediate care in the note record.

 

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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.