NEW FEE CODES AND RE-DEFINED FEE CODES

The following is a list of all new fee codes and fee codes which have been redefined or

reworded, which are now incorporated into the Tariff of Fees, attached hereto as Schedule “A”.

New fee codes are flagged with an asterisk (*), and redefined fee codes are shown with the wording changes in the service descriptions in italics.

All new and substantively redefined fees listed here shall be effective as of January 1, 2012.

Increases to all other fees listed in the Tariff of Fees shall be effective on October 1, 2011.

Description ^Fee _Code ^Apr-01 ₂₀₁₀ ^Oct-01 ₂₀₁₁ ^Oct-01₂₀₁₂ ^Oct-01₂₀₁₃ ^Oct-01₂₀₁₄

On-Call Services

On-Call Retainer - Urban GP group of 5 - 7 ... 0019 150.00 161.25 180.00 198.75 225.00 On-Call Retainer - Souris, Tyne Valley, O'Leary, Montague (per hospital) ... 0185 150.00 161.25 180.00 198.75 225.00 On-Call Retainer - Alberton ... 0040 260.00 260.00 260.00 260.00 260.00 On-Call Retainer - Coroner (East or West) ... * 0020 150.00 150.00 150.00 150.00 150.00 On-Call Retainer - Corrections ... * 0030 200.00 203.75 210.00 216.25 225.00 On-Call Response Fee... * 0060 50.00 80.00 110.00 150.00

Hospitalist Medicine

Hospitalist Type 1 daily sessional fee - max. 21 beds... 0107 1,265.00 1,267.25 1,271.00 1,274.75 1,280.00 Hospitalist Type 1 daily sessional fee - max. 11 beds... * 0102 664.00 666.00 668.00 670.00 Hospitalist Type 2 daily sessional fee - max. 17 beds... * 0101 1,265.00 1,279.25 1,303.00 1,326.75 1,360.00 Hospitalist Type 2 daily sessional fee - max. 09 beds... * 0037 677.00 690.00 702.00 720.00 Hospitalist Type 1 sessional top-up fee (Salary Class I) - max. 21 beds... * 0038 595.51 592.33 587.01 581.70 574.26 Hospitalist Type 1 sessional top-up fee (Salary Class II) - max. 21 beds... * 0039 576.37 573.01 567.41 561.80 553.96 Hospitalist Type 1 sessional top-up fee (Salary Class III) - max. 21 beds ... * 0041 547.70 544.06 538.03 532.00 523.57 Hospitalist Type 1 sessional top-up fee (Salary Class I) - max. 11 beds... * 0042 310.27 307.48 304.70 300.80 Hospitalist Type 1 sessional top-up fee (Salary Class II) - max. 11 beds... * 0043 300.15 297.21 294.28 290.17 Hospitalist Type 1 sessional top-up fee (Salary Class III) - max. 11 beds ... * 0044 284.98 281.83 278.67 274.25 Hospitalist Type 2 sessional top-up fee (Salary Class I) - max. 17 beds... * 0025 595.51 604.33 619.01 633.70 654.26 Hospitalist Type 2 sessional top-up fee (Salary Class II) - max. 17 beds... * 0026 576.37 585.01 599.41 613.80 633.96 Hospitalist Type 2 sessional top-up fee (Salary Class III) - max. 17 beds ... * 0027 547.70 556.06 570.03 584.00 603.57 Hospitalist Type 2 sessional top-up fee (Salary Class I) - max. 09 beds... * 0045 319.94 327.71 335.49 346.37 Hospitalist Type 2 sessional top-up fee (Salary Class II) - max. 09 beds... * 0046 309.71 317.33 324.95 335.62 Hospitalist Type 2 sessional top-up fee (Salary Class III) - max. 09 beds ... * 0047 294.38 301.78 309.18 319.53

Emergency Medicine

ER sessional top-up fee (Salary Class I) ... 0005 75.74 76.51 77.80 79.09 80.90 ER sessional top-up fee (Salary Class II)... 0006 73.18 73.93 75.19 76.44 78.19 ER sessional top-up fee (Salary Class III) ... 0007 69.36 70.07 71.27 72.47 74.14 Emergency Procedural Sedation... 2011 25.00 25.75 27.00 28.25 30.00

Description ^Fee _Code ^Apr-01 ₂₀₁₀ ^Oct-01 ₂₀₁₁ ^Oct-01₂₀₁₂ ^Oct-01₂₀₁₃ ^Oct-01₂₀₁₄

Palliative Care

Palliative Care Unit Inpatient - initial visit... * 0163 66.00 76.00 86.00 100.00 Palliative Care Unit Inpatient - daily care visit ... * 0164 37.25 41.00 44.75 50.00

Dermatology

G.P. Dermatology consultation (designated physicians only)... * 0137 75.00 76.50 78.00 80.00 Tele-Dermatology consultation ... * 0350 40.75 42.00 43.25 45.00

Telephone Services

Telephone consultation - Pediatric... * 1120 40.75 42.00 43.25 45.00 Telephone prescription renewal (1 or more per patient per month) ... * 2019 3.00 3.50 4.00 5.00

Neurology

Electromyography (major) - examination of muscles of more than one region ... 2149 82.00 83.20 85.20 87.20 90.00 Electromyography (minor) - examination of muscles of a specific limb or region... 2150 53.60 54.56 56.16 57.76 60.00 Nerve Conduction Studies, per nerve studied (maximum 6 nerves) ... 2140 28.52 28.82 29.32 29.82 30.52 Nerve entrapment evaluation (composite fee)... * 2166 80.00 81.68 83.36 85.60

Dialysis Management

Acute Dialysis - first treatment ... * 2055 585.00 585.00 585.00 585.00 Acute Dialysis - subsequent treatment (up to 2)... * 2056 268.80 268.80 268.80 268.80 Chronic Dialysis - first treatment... 2135 170.85 172.64 175.63 178.62 182.81 Chronic Dialysis - subsequent treatment (max. 3 per patient per week) ... 2137 102.50 74.00 74.00 74.00 74.00 Satellite Dialysis Management (per patient per week) ... * 2058 40.00 40.00 40.00 40.00 Dialysis catheter - tunneling and insertion ... * 2038 150.00 150.00 150.00 150.00 Dialysis catheter - removal and/or replacement ... * 2039 200.00 200.00 200.00 200.00

Gastroenterology

Removal of rectal foreign body... * 2021 72.25 76.00 79.75 85.00 Argon Coagulation of stomach or rectum - single or multiple (add-on fee)... * 2022 75.00 76.58 78.15 80.25 Ileoscopy... * 2315 57.50 70.00 82.50 100.00

Respirology

Bronchoscopy with Transbronchial Lung Biopsy - single lobe... 4210 196.00 198.06 201.49 204.92 209.72 Bronchoscopy with Transbronchial Lung Biopsy - each additional lobe... * 4212 50.00 51.05 52.10 53.50 Bronchoscopy with Transbronchial Needle Aspiration (TBNA) of lymph nodes... * 4213 198.06 201.49 204.92 209.72 Endobronchial Ultrasound (EBUS)... * 4214 269.98 274.66 279.33 285.88

Cardiology

Insertion - dual chamber pacemaker or ICD (Medical)... * 4781 252.63 257.00 261.38 267.50 Insertion - dual chamber pacemaker or ICD (Surgical)... * 4782 408.09 415.16 422.23 432.12 Reprogram or Interrogate pacemaker (including ICD)... 4776 80.00 80.84 82.24 83.64 85.60

Critical Care

Critical Care - Days 2-30 inclusive, per day ... 0597 160.00 161.20 163.20 165.20 168.00 Critical Care - Day 31 onward, per day... 0598 80.00 80.60 81.60 82.60 84.00 Pediatric Critical Care - Days 2-30 inclusive, per day ... 1156 160.00 161.20 163.20 165.20 168.00 Pediatric Critical Care - Day 31 onward, per day... 1157 80.00 80.60 81.60 82.60 84.00 Neonatal ICU Care - Days 2-30 inclusive, per day ... 1146 165.00 166.50 169.00 171.50 175.00 Neonatal ICU Care - Day 31 onward, per day ... 1147 110.00 110.90 112.40 113.90 116.00

89

-Description ^Fee _Code ^Apr-01 ₂₀₁₀ ^Oct-01 ₂₀₁₁ ^Oct-01₂₀₁₂ ^Oct-01₂₀₁₃ ^Oct-01₂₀₁₄

Anesthesia Critical Care - Day 31 onward, per day ... 0298 80.00 80.60 81.60 82.60 84.00

Gynecology

Laparoscopic Hysterectomy - total, abdominal or vaginal ... * 6958 526.79 535.91 545.03 557.80 Laparoscopic Hysterectomy - partial or subtotal, with or without adnexa ... * 6959 389.93 396.68 403.43 412.89 Omental Biopsy - single or multiple (add-on fee)... * 6631 50.00 51.05 52.10 53.50 Conization of Cervix without D&C (LEEP) ... * 6632 60.00 61.26 62.52 64.20 Sacrospinous vault fixation (add on)... 6952 95.00 96.00 97.66 99.32 101.65 Biopsy of Cervix - office procedure, without colposcopy ... 6929 30.85 31.17 31.71 32.25 33.01 Colposcopy without biopsy ... 6934 79.05 79.88 81.26 82.65 84.58 Colposcopy with biopsy (includes Pap) ... * 6989 111.05 112.98 114.90 117.59 Perineorrhaphy (without rectocele repair) ... 6608 129.75 131.11 133.38 135.65 138.83

Ophthalmology

Optical Coherence Tomography (OCT) - composite fee (max.. 4 per year)... 2414 57.05 57.65 58.65 59.65 61.04 Optical Coherence Tomography (OCT) - technical fee (max. 4 per year) ... * 2417 42.49 43.23 43.96 44.99 Optical Coherence Tomography (OCT) - professional fee (max. 4 per year) ... * 2415 15.16 15.42 15.68 16.05 IOL Master / Ocular Biometry - procedure only... * 2420 38.30 38.96 39.62 40.55 IOL Master / Ocular Biometry - interpretation ... * 2421 19.39 20.20 21.01 22.15 Pneumatic Retinopexy ... * 7259 660.18 660.18 660.18 660.18 Pneumatic Retinopexy - repeat same eye within 30 days... * 7260 330.09 330.09 330.09 330.09

Urology

Intravesical Botox injections (1 or more)... * 8250 202.10 205.60 209.10 214.00 Urethrolysis (includes cystoscopy) ... * 8339 350.00 357.35 364.70 374.50 Insertion of testicular prosthesis (Prior approval required for age 18 yrs and over) ... 8507 161.00 162.69 165.51 168.33 172.27

Radiology

SPECT (nuclear scan tomography) - add-on fee ... * 8799 25.00 25.00 25.00 25.00

Radiation Oncology

Radiation Oncology Consultation ... 1760 85.00 100.75 127.00 153.25 190.00 Radiation Oncology Follow-up visit ... 1713 19.35 21.70 25.61 29.52 35.00

Miscellaneous

Autopsy - non-coroner's on evenings and weekends... 1900 679.00 764.65 907.40 1,050.15 1,250.00 Tram Flap - first surgeon ... 3097 I.C. I.C. I.C. I.C. I.C.

Tram Flap - second surgeon... 9999 I.C. I.C. I.C. I.C. I.C.

PAIN MANAGEMENT

Chronic Pain Consultation... 0250 85.00 87.70 92.20 96.70 103.00 Chronic Pain Follow-up visit... 0252 33.00 33.30 33.80 34.30 35.00

Peripheral Nerve blocks

Somatic or peripheral nerve not specifically listed - single ... 2183 36.00 36.60 37.60 38.60 40.00 Somatic or peripheral nerve not specifically listed - each additional (to max. of 4) ... 2184 18.00 18.30 18.80 19.30 20.00 Cervical plexus... 2186 70.00 70.74 71.96 73.19 74.90 Brachial plexus... 2189 60.00 60.63 61.68 62.73 64.20 Supraorbital branch of Ophthalmic Nerve (Trigeminal) ... * 2450 60.63 61.68 62.73 64.20 Infraorbital branch of Maxillary Nerve (Trigeminal) ... 2188 60.00 60.63 61.68 62.73 64.20 Mental branch of Mandibular Nerve (Trigeminal)... 2187 60.00 60.63 61.68 62.73 64.20

Description ^Fee _Code ^Apr-01 ₂₀₁₀ ^Oct-01 ₂₀₁₁ ^Oct-01₂₀₁₂ ^Oct-01₂₀₁₃ ^Oct-01₂₀₁₄

Maxillary or Mandibular division of Trigeminal Nerve... 2206 70.00 70.74 71.96 73.19 74.90 Therapeutic Seventh Cranial nerve block - unilateral ... 2304 42.00 42.44 43.18 43.91 44.94 Therapeutic Seventh Cranial nerve block - bilateral ... 2305 63.05 63.71 64.82 65.92 67.46 Other Cranial Nerve ... * 2451 60.63 61.68 62.73 64.20 Occipital Nerve ... 2100 31.05 32.39 34.63 36.87 40.00 Transverse Scapular Nerve ... * 2452 60.63 61.68 62.73 64.20 Intercostal Nerve - single ... * 2453 36.60 37.60 38.60 40.00 Intercostal Nerve - each additional (to max. of 4)... * 2454 18.30 18.80 19.30 20.00 Paravertebral Nerve - single... 2210 70.00 70.74 71.96 73.19 74.90 Paravertebral Nerve - each additional (to max. of 4) ... 2211 35.00 35.37 35.98 36.59 37.45 Ilioinguinal and/or Iliohypogastric Nerves... * 2455 60.63 61.68 62.73 64.20 Sciatic Nerve... 2192 60.00 60.63 61.68 62.73 64.20 Femoral Nerve ... * 2456 60.63 61.68 62.73 64.20 Obturator Nerve ... 2193 60.00 60.63 61.68 62.73 64.20 Pudendal Nerve... 2194 50.00 60.63 61.68 62.73 64.20 Lateral Femoral Cutaneous Nerve... 2204 70.00 70.00 70.00 70.00 70.00 Combined 3-in-1 block (femoral, obturator, lateral femoral cutaneous) ... * 2457 80.84 82.24 83.64 85.60 Fascia Iliaca Compartment block... * 2458 60.63 61.68 62.73 64.20 Transversus Abdominis Plane (TAP) block - unilateral... * 2459 30.32 30.84 31.37 32.10 Transversus Abdominis Plane (TAP) block - bilateral... * 2460 50.02 50.89 51.75 52.97 Nerve block with fluoroscopic guidance (add on)... * 2461 40.75 42.00 43.25 45.00 Nerve block with ultrasound guidance (add on)... * 2462 25.75 27.00 28.25 30.00 Nerve block with alcohol or other sclerosing agent - add 50% (with comment)... *

Vertebral Facet Joint injections

Vertebral Facet Joint injection - with fluoroscopic guidance (single)... 2533 50.00 91.28 93.40 95.53 98.50 Vertebral Facet Joint injection - with fluoroscopic guidance (each additional, up to 6)* 2463 59.33 60.71 62.09 64.03 Vertebral Facet Joint injection - with ultrasound guidance (single) ... * 2464 76.28 78.40 80.53 83.50 Vertebral Facet Joint injection - with ultrasound guidance (each additional, up to 6).. * 2465 49.58 50.96 52.34 54.28

Sacroiliac Joint injections

Sacroiliac Joint injection - with fluorscopic guidance (unilateral) ... * 2466 91.28 93.40 95.53 98.50 Sacroiliac Joint injection - with fluorscopic guidance (bilateral) ... * 2467 150.60 154.11 157.62 162.53

Nerve Root injections

Diagnostic nerve root block - with fluoroscopic guidance (any number of sites) ... * 2468 161.68 164.48 167.28 171.20

Epidural injections

Cervical epidural injection - with fluoroscopic guidance... 2531 120.00 161.68 164.48 167.28 171.20 Thoracic epidural injection - with fluoroscopic guidance ... 2532 120.00 161.68 164.48 167.28 171.20 Lumbar epidural injection - with fluoroscopic guidance... 2524 160.00 161.68 164.48 167.28 171.20 Caudal epidural injection... 2191 65.00 65.68 66.82 67.96 69.55 Epidural - single injection ... 2196 80.00 80.84 82.24 83.64 85.60 Subarachnoid (diagnostic spinal) ... 2195 70.00 70.74 71.96 73.19 74.90

Sympathetic Nerve injections

Cervical sympathetic or Stellate ganglion block... 2199 100.00 101.05 102.80 104.55 107.00 Cervical sympathetic or Stellate ganglion block - with U/S or fluoroscopic guidance .. 2208 150.00 151.58 154.20 156.83 160.50 Thoracic, Lumbar, Sacral sympathetic block - with fluoroscopic guidance ... 2205 150.00 151.58 154.20 156.83 160.50

91

-Description ^Fee _Code ^Apr-01 ₂₀₁₀ ^Oct-01 ₂₀₁₁ ^Oct-01₂₀₁₂ ^Oct-01₂₀₁₃ ^Oct-01₂₀₁₄

Ganglion/Plexus injections

Presacral (superior hypogastric plexus) block ... 2190 60.00 60.63 61.68 62.73 64.20 Celiac, splanchnic or hypogastric ganglion/plexus block - with fluoroscopic guidance 2197 100.00 151.58 154.20 156.83 160.50 Trigeminal (Gasserian) ganglion block ... 2198 100.00 101.05 102.80 104.55 107.00 Trigeminal (Gasserian) ganglion block - with fluoroscopic guidance... 2202 150.00 151.58 154.20 156.83 160.50 Spheno-palatine ganglion block - with fluoroscopic guidance... 2207 70.00 151.58 154.20 156.83 160.50 Superior Laryngeal Nerve - with fluoroscopic guidance... 2209 150.00 151.58 154.20 156.83 160.50

Other anesthetic injections

IV Guanethidine/Bier Block... 2530 100.00 101.05 102.80 104.55 107.00 Trigger point injection (myoneural pain block) with local anesthetic (one or more) ... 2101 20.00 20.21 20.56 20.91 21.40

SCHEDULE A

Schedule of Payments