Services Provided in the Emergency Room Take quiz

The following three factors determine the appropriate visit fee to bill when service is provided in the emergency room:

  • whether the physician is the designated emergency room physician (doctor of the day);
  • where the physician is located when called to the emergency room; and,
  • the time of day.

The following examples illustrate the correct billing for three different situations:

Example 1:

Physician is the emergency physician designated by the medical staff, and is on hospital Emergency Department duty and is on-site:

What to bill:
Bill the appropriate fee item from the 01800 series in the Emergency Medicine section of the MSC Payment Schedule.


The 01800 series is applicable to certified and non-certified Emergency Room Physicians (except for the consultation fee). Fee items 13200/13300 are not appropriate in these cases.

Example 2:

Physician is already at the hospital when called to see a patient in the emergency room, but is not on a scheduled shift in the emergency room.

What to bill:
Bill the appropriate on-call, on-site hospital visit fee if service is between 1800 and 2300 hours, or on a weekend or statutory holiday (i.e., 00113, 00105, or 00123). For weekday services between 0800 and 1800 hours, bill the appropriate out-of-office visit fee (e.g., 13200).

Example 3:

Physician is called from home to attend a patient in the emergency room on an urgent basis.

What to bill:
Bill the appropriate visit fee plus call-out if out-of-office hours, or the appropriate emergency visit fee (e.g. 00112) if during the day.

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