Obstetrical Visits

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.

Billing Notes

For claiming supplementary tariffs in relation to Obstetrical care:

  • Visits that are for conditions unrelated to pregnancy may be billed under the appropriate visit fee;
  • Necessary laboratory investigations are payable in addition to obstetrical fees;
  • Serious complications that require hospitalization prior to delivery are not included in the benefits provided for obstetrical care and should be billed by Special Report (Visits, hospital daily care, tests and other fees should be billed as if the case were a typical hospital patient).
Questions?

Braden Kalichuk
bkalichuk@docsmb.org
(204) 985-5848

 

Updated: November 2016