Physicians are able to claim several tariffs in relation to maternity services. Typically physicians will claim for one comprehensive pre-natal assessment, followed by 10-12 routine pre-natal visits and one post-natal visit. The following lists obstetrical visit tariffs along with the related rules and guidelines for claiming each tariff (as set out in Rule of Application #33).
Tariff 8400 – Comprehensive pre-natal assessment
- Assessment should include a full patient history, an inquiry into and examination of all relevant parts or systems, a comprehensive pelvic examination along with completion of the pre-natal record and advice to the patient;
- Should generally last 20 minutes or longer; otherwise claim as appropriate visit fee (Complete, Regional or Basic visit);
- Should only be billed once per pregnancy.
Tariff 8401 – Pre-natal visit
- Visit should include the necessary history, examination, appropriate record and advice to the patient (including any pregnancy related counseling or advice to the patient or patient’s representative(s);
- Visits should generally occur at four week intervals to 28 weeks, every 2ndweek up to 36 weeks, and then weekly until delivery;
- Complicated pregnancies may require additional visits, which should all be claimed as tariff 8401.
Tariff 8402 – Post-natal visit
- Visit should include the necessary history, examination, appropriate record and advice to the patient;
- May only be billed once following delivery during the post-natal period (42 days after delivery);
- Complicated pregnancies may require additional visits, which should beclaimed as the appropriate office, home or hospital visit.
For claiming supplementary tariffs in relation to Obstetrical care:
Updated: November 2016