MSU. This service is paid to family physicians who are delivering face to face comprehensive and continuous care to patients aged 65 or older with whom they have an ongoing relationship. This fee code does not have multiples. For visits that are longer than 15 minutes in the office, physicians can bill prolonged office visits (03.03 + MU). If billing 03.03 + MU for patients aged 65 or older, you must include start and stop times are required in the text field of the claim and documented in the patient’s health record. Otherwise, 3.03A does not require start and stop times. Evening and weekend premiums (GPEW) apply to this code. Location = office (OFFC)
3.03 17 MSU + MU (17 MSUs per 15 minutes) This service is paid to family physicians who are delivering face to face comprehensive and continuous care to patients with whom they have an ongoing relationship. Only physicians eligible to bill the ME=CARE modifier may bill for prolonged office visits. Each office visit can be billed to a maximum of 60 minutes (68 MSUs) per patient per day. This would include a base visit plus up to 3 multiples of 15 minutes each. Prolonged office visits are paid in 15-minute time blocks or portion thereof. 80% of the time must be direct physician to patient contact. Prolonged office visits are not to be confused with active treatment associated with detention. Multiples Total Time MU = 2 30 minutes MU = 3 45 minutes MU = 4 60 minutes Start and stop times are required for any visit that bills multiples. These start and stop time must be included in the text field when the claim is submitted. Start and stop times are not required for visits that do not require multiples. Multiples are not applicable for virtual care. Evening and weekend premiums (GPEW) apply to this code including multiples. Location = office (OFFC) The prolonged office visit can be billed for patients aged 65 and over when the visit is longer than 15 minutes. This code plus multiples is billed instead of 3.03A.
MSU
