Delivery of Health Supports by a Clinical Nurse Consultant - Weekday Evening

When to use this code

Use this code for community nursing care delivered during evening hours (after 6pm). Nursing care includes clinical tasks such as wound management, medication administration, catheter care, and health monitoring. Evening loading compensates support workers for working outside standard business hours.

Common billing scenarios

• A registered nurse visits a participant for wound care, spending 1 hour on assessment and treatment. The provider claims 1 hour at $186.63.
• A nurse conducts a medication review and health check, taking 45 minutes. The provider rounds to the nearest billing increment as per the service agreement.

Provider notes

• Non-face-to-face delivery is allowed for this code. This means you can bill for activities like report writing, care coordination calls, or progress notes, provided your service agreement with the participant covers these activities. Keep clear records of what non-face-to-face work was done and how long it took.
• This code allows provider travel claims. Travel time to the participant can be billed, but keep in mind the NDIA expects travel to be reasonable. If you are seeing multiple participants in one area, split the travel cost across their plans.
• Short notice cancellation fees apply. If a participant cancels with less than 7 clear days notice (or 2 clear business days for some supports), you can charge up to 90% of the agreed fee. You must document the cancellation and have the cancellation policy in your service agreement.
• Core supports are the most commonly claimed category. Make sure your service agreements clearly state the code, rate, and cancellation terms. This reduces disputes at claiming time.
• Nursing services must be delivered by a registered nurse (RN) or enrolled nurse (EN) working within their scope of practice. Keep clinical records that meet AHPRA standards and ensure your professional registration is current.