A817 – Midwife or Aboriginal Midwife-Requested Special Assessment (MAMRSA) by Video
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A Midwife or Aboriginal Midwife-Requested Special Assessment (MAMRSA) by Video is an assessment of a mother or newborn provided by a physician upon the written request of a midwife or Aboriginal Midwife because of the very complex, obscure, or serious nature of the patient’s problem. It is intended for urgent or emergency assessments of a newborn by a paediatrician, or for complex assessments of a mother or newborn by a family physician or obstetrician.
When to Use
- Bill A817 for a pediatrician's urgent video assessment of a newborn with concerning feeding difficulties and dehydration, requested in writing by a midwife.
- Use A817 when an obstetrician provides a complex video assessment for a mother experiencing severe pre-eclampsia symptoms, as requested by an Aboriginal midwife.
- Bill A817 for a family physician's video assessment of a newborn with suspected rare genetic condition, following a written request from a midwife due to the complexity.
Common Pitfalls
- Billing A817 without a written request from a midwife or Aboriginal midwife on file is a common rejection reason.
- Failing to document the full 50 minutes of direct patient contact time, exclusive of other billable services, can lead to the claim being re-assigned to A814.
- Not submitting findings verbally and in writing to the midwife, and in writing to the primary care provider, can result in claim issues or audits.
Billing Tips
- Ensure the video modality indicator K300A is appended to the claim to signify the virtual care format.
- A817 is limited to one per patient per physician per pregnancy, so verify no prior A817 or A815 claims exist for this patient within the same pregnancy.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Virtual Care (Video Only)
Assessment
A written request from a midwife or Aboriginal midwife is required. Urgent or emergency requests may be initiated verbally but must be followed by a written request. The written request must be retained on the patient’s permanent medical record.
The physician must spend at least 50 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
The start and stop times of the assessment must be recorded on the patient’s permanent medical record.
The assessment must include the common and specific elements of a specific assessment (as defined in ) and the constituent elements of A814.
The physician must submit findings, opinions, and recommendations: (1) verbally to the midwife, (2) in writing to the midwife, and (3) in writing to the patient’s primary care physician or nurse practitioner (if applicable).
Calculation of time excludes non-patient-facing time (e.g., reviewing charts, imaging, or documentation).
Payable in any setting.
Eligible for age-based fee premiums as per the Age Premium Table in (e.g., 30% increase for newborns less than 30 days of age).
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