When a surgeon performs a major surgical service and is not available to provide the postoperative care for the patient, care may be transferred to another physician. Most commonly this occurs when an itinerant surgeon performs a major surgery and a local physician agrees to provide the subsequent care for the patient. Although the postoperative care has been transferred, the surgeon may still provide (and may be paid for) some care during the postoperative period. The physician who accepts care of the patient postoperatively will be paid for all services rendered.
Claims for postoperative care services when care is transferred from the surgeon to another physician are to be made in accordance with Rule of Application #31.
Postoperative Surgical Care:
“Postoperative Surgical Care is the responsibility of the surgeon. If a postoperative patient is transferred to the care of another physician, that physician may claim for the services rendered, and benefits paid to this physician may be deducted from payment made to the surgeon up to a maximum of 15% of the surgeon’s fee”
Note that this rule must be read in conjunction with Rule of Application #23 which indicates that the benefits for MAJOR surgical services include three (3) weeks postoperative care.
Updated: November 2016