Consultation – Unassigned Patient — Tariff 8595
Tariff 8595 Consultation — Unassigned Patient may be claimed by specialists in the blocs of Internal Medicine, Neurology, Rheumatology, Cardiology, Gastroenterology, Nephrology, Medical Genetics, Physical Medicine, Malignant Disease Specialists, Radiation Oncology, Psychiatry, General Surgery, Cardiac Surgery, Orthopaedic Surgery, Vascular Surgery and Thoracic Surgery. Section “A” of the Physician’s Manual, under the heading Hospital Care, describes the tariff as:
“Unassigned patient” means a patient who requires assessment by a (specialist) who has not rendered a Complete History and Physical Examination (Tariff 8540) or Consultation service (Tariff 8550 or Tariff 8595) to that patient within the last twelve consecutive months.
Rules of Application 7 through 10 apply.
Note: Psychiatrists, please refer to your visit page for the specific Psychiatry definition.
Tariff 8595 may be billed under the following circumstances:
- Tariff 8595 may be claimed for patients:
- who present for assessment at an emergency department, regardless of whether or not an admission to hospital follows the consultation, or
- who are registered bed patients formally admitted to hospital.
- Tariff 8595 may not be claimed for patients who present at the out-patient department/clinic or a physician’s office.
- An “Unassigned Patient” is determined solely by whether the specialist has rendered a “Complete” (Tariff 8540) or “Consultation” (Tariff 8550 or 8595) service in the past twelve months to the patient. The fact that the specialist may have rendered other procedures or services, e.g. regional examinations, subsequent visits or hospital care services during the previous twelve months, is irrelevant.
- The consultation must comply with Rules of Application 7 through 10
- Tariff 8595 may be claimed for the patient on the same day by multiple specialists
Where specialists in the same bloc of practice see the same patient on the same day, Manitoba Health may downgrade the second specialist’s claim to Tariff 8550.
If that occurs, please contact Doctors Manitoba.