Many physicians working in a hospital setting have heard of admission and MRP premiums but they don’t always apply the premiums when appropriate. Below, we look at the E082 MRP (most responsible physician) admission premium and the E083 MRP premium for subsequent hospital visits in greater detail.
The intent in the Schedule of Benefits is for the MRP who does follow up care to bill both the admission premium and the daily visit MRP premiums. In practice, hospitals have different policies on billing the E082, while the E083 is relatively straightforward to apply. Check with your Chief of Medicine to see whether specialists in the Emergency Department can bill the E082, or if it should be left for the hospitalist to bill the next day.
E082 – 30% Premium on admission assessment by the MRP
When a physician does a consultation in hospital and admits the patient to their service, the 30% E082 premium applies to the consultation code. Most often the consult takes place in the emergency department, but the admission assessment can also occur on an inpatient ward. This code requires the admit date for submission to the MOH; this should be the same date as the consultation, though one day leeway is allowed if the patient arrived in the Emergency department the day before.
ER admission by specialist
|A135||Internal Medicine Consultation||$157.00|
|E082||MRP Admission Assessment||$48.00|
|K995||Special visit to ER, Evening||$60.00|
ER admission by GP hospitalist
|A933||Internal Medicine Consultation||$79.90|
|E082||MRP Admission Assessment||$23.97|
|K999||Special visit to ER, Weekend||$75.00|
E083 – 30% Premium on subsequent visit by the MRP
This 30% premium is billable on all MRP subsequent visit codes. The premium is meant for the attending physician or hospitalist who is the most responsible physician for that patient. It can also be billed by a physician filling in for the MRP during the weekend or a holiday. E083 is not specialty specific, and can be billed for any specialist or GP hospitalist following an inpatient.
Examples of MRP subsequent visit codes
|C122||Day 1 after admission||E083||$58.80 + $17.64|
|C123||Day 2 after admission||E083||$58.80 + $17.64|
|C002/C132||Subsequent visit *||E083||$31.00 + $9.30|
|C124||Day of discharge||E083||$58.80 + $17.64|
|C121||Visit due to intercurrent illness||E083||$31.00|
* the two middle digits represent the MD’s specialty – “00” for GP’s, “13” for Internal Medicine
Limitations to E082 & E083
Both codes are subject to certain limitations. They can only be billed once per day: two physicians won’t be paid the E083 or E082 for the same patient. Also, the physician cannot be receiving remuneration from the hospital for inpatient treatment. If they are, E083 isn’t billable.
Finally, if either of these codes are not paid on the RA, there is no recourse for appeal. Physicians are expected to know when they are MRP for a patient, and to bill accordingly.
For more on inpatient hospital billing, see our blog series: