Virtual Care Professional Billing Codes - COVID Considerations

We've previously posted about new Virtual Care Professional Billing codes. Questions arise related to e-consults and e-visits within and without health care facilities, with Dr Adrian Wagg providing these clarifications:

  • The pandemic code 03.08CV can be billed from anywhere and can be used for inpatient virtual consults as much as any other virtual consultation.  The AMA suggests that being in the same facility should be no barrier to the use of this code.
  • The code 03.03FV is for outpatient follow up only as indicated in its name description, so please use this accordingly.
  • The code 03.03CV is for unreferred limited assessment, but there's nothing in the rules preventing the use of 03.03CV to bill virtual inpatient encounters.
  • Note: at a minimum a physician must complete a limited assessment of a patient's condition requiring a history related to the presenting problems, appropriate records, and advice to the patient. The assessment must last a minimum of 10 minutes. An assessment that does not meet the minimum requirements or is less than 10 minutes must be claimed using 03.01AD
  • Existing codes deal with telephone consultations with nursing, pharmacy and allied health staff - this is unchanged from usual practice.
All codes are fully configured and operational within Connect Care.

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