Updated March 2025
On February 1, 2023, the Ministry of Health launched the Longitudinal Family Physician (LFP) Payment Model aimed at enhancing, supporting, and protecting British Columbia’s healthcare system and patient care. Since this model was implemented two years ago, over 4,000 physicians have joined the program, an increase from 3,000 in 2023.
Adjusting to a new payment model can be daunting and may take time away from patient care. To assist physicians in understanding the specifics and advantages of the LFP payment model, we have compiled a list of the most common questions we have received from our doctors.
Enrolment
If physicians don’t have a starting panel of 250 patients, can they still enroll into the LFP?
You do not need to have a panel of patients prior to enrolling in the LFP Payment Model. You must, however, have at least 250 empanelled patients within four months of enrolling in the LFP Payment Model.
Within three months of enrolling, you must develop and submit an accurate list of empanelled patients to date. (We recommend submitting your empanelled patients on a regular basis.)
I need to submit a few claims prior to enrolling into the LFP payment model. Is it still possible for me to submit them under the traditional MSP model?
Yes, you can submit any fee-for-service claims that took place before the date you registered for the new LFP payment model.
Panel Payment
How is the patient/panel complexity calculated?
Panel payment amounts for 2024 are calculated based on the Community Longitudinal Family Physician (CLFP) Payment to estimate the size and complexity of a longitudinal family physician’s patient panel. In this methodology, the number of patients is estimated using the Majority Source of Care (MSOC) methodology and complexity is measured using the Adjusted Clinical Group (ACG) system.
Note: we recommend using all three Dx spots, if applicable, to help capture and monitor complexity.
Billing & Payment
If I see a patient virtually but then need to see them in person on the same day, can I bill for both visits?
Here is what you need to know if you have multiple visits by the same patient in one day:
- You can bill direct patient care.
- You cannot bill a second patient interaction code unless the second visit is for
- A new condition; or
- The condition has worsened significantly and requires a new assessment.
- To bill more than one patient interaction code for the same patient on the same calendar day:
- Provide the time for each interaction in the time for each patient interaction code;
- Provide a note record indicating the reason for the second interaction; and
- Use submission code “D” for the second patient interaction code.
Can I bill an interaction code when my nurse practitioner performs an injection for a patient?
From Oct 1, 2024-March 31, 2025, you can bill for influenza, pneumococcal, pertussis, and COVID-19 immunizations provided by allied care providers employed by a physician practice. This is done using the temporary code ‘98101 LFP Respiratory Immunization Provided by an Allied Care Provider’.
In order to bill this code, the Allied Care Provider must be paid out of practice earnings to work directly within the practice with no cost recovery either directly or indirectly from a third party (e.g. Health Authority, Division of Family Practice, Ministry of Health).
Is there any restriction on billing indirect time (reviewing labs, research) on the weekend?
There are three time code limits for clinic-based care:
- The maximum number of hours payable daily for clinic-based care is 14 hours per day.
- The maximum number of hours payable for clinic-based care in any 14-day period is 120 hours. (This means that each day of the week cannot meet the daily maximum.)
- The maximum amount of hours payable as Clinical Administration time (98012, 98042) is 10% of the total amount of clinic-based time codes paid in a calendar year.
I start my day reviewing results. Do I bill that under the patient whose first result I reviewed and document the start and end time for that patient?
For each date of service, all time codes must be submitted on a single personal health number (PHN) for each clinic or facility setting.
Time codes are submitted using the PHN and demographic information of the first patient of the day for whom an interaction code was billed in that setting.
On a day when only Indirect Patient Care or Clinical Administration is provided, use the information of the last LFP patient for whom an interaction code was billed in any clinic or Facility setting. Start and end times must be entered on the billing claim for each time code.
Note: Start and end times for each time code must not overlap. One or more claims may be submitted for each time code each day. If more than one submission of the same time code is required to avoid overlapping times, physicians must use submission code “D” on the billing claim.
Venereal warts are listed as an advanced procedure, but cryotherapy is listed as a minor procedure. Should I be billing under advanced or minor procedures?
Venereal warts are included under the interaction code 98020. All other cryotherapy is under interaction code 98022.
I spoke with a patient on the phone about their lab results. Can I bill for the 98032, or do I bill for .5 units?
You can bill the 98032 fee code and 98010 time billing code, but would not be able to bill .5 units.
If a doctor consults via phone with another physician regarding a patient, what should they bill that time under?
The physician would bill this time under indirect patient care.
Exclusions
Will I continue to receive CLFP payment if I move to the LFP payment model?
The Community Longitudinal Family Physician (CLFP) Payment is an FPSC payment that is primarily intended to provide financial support to fee-for-service family physicians who maintain relational continuity with a panel of patients. As a result, it will not be paid to physicians who move from fee-for-service to the LFP payment model.
Instead, physicians being paid under the LFP payment model will receive a panel payment based on the number of active patients and the complexity of those patients.
Can I bill an additional visit when I see patients for other conditions unrelated to an ICBC visit?
Services like ICBC, RoadSafetyBC, and WorkSafeBC cannot be billed under the LFP Payment model. These visits need to be billed under fee-for-service.
However, if you see the patient for a different condition in the same visit, you can bill an interaction code 98031. You would need to ensure the diagnostic (Dx) code is different from the fee for service claim.
Note: even if you are eligible for the 98031, you cannot bill the time codes for this service.
My practice provides more than 30% of non-panel services. Can I still enroll into the LFP payment model?
A physician is not required to meet the requirement that states that- Clinic Non-panel Services are no more than 30% of LFP Clinic-based Services– until June 30, 2025, if they are actively transitioning their clinic-based services to meet this requirement and submit:
- an LFP Clinic-based Services Transition Code (98001) on or after September 1, 2024; and
- an LFP Clinic-based Services Transition Form on or after September 1, 2024.
If both the Transition Code and Transition Form are not submitted, a physician enrolled in the LFP Payment Model must ensure that non-panel services are no more than 30% of LFP clinic-based services, except for physicians practicing in rural communities.
If you would like to learn more about how to submit the transition code, visit the updated LFP payment schedule here.
Locums
Do locums need to enroll under the new LFP payment model?
Yes. Locums can enrol by:
- Submitting the Locum Enrolment code 98005 via Teleplan AND
- Submitting a LFP locum registration form
Do these steps at least one business day prior to submitting billing under the LFP Payment Model.
Can locums bill indirect and administration codes?
Locums have their own specific time and interaction codes that they can bill under the LFP payment model.
General
What percentage can a doctor work from home under the new LFP payment model?
Doctors need to ensure they provide in-clinic services atleast one day per week. LFP physicians working from home is billed as indirect time.
What does out-of-province patient mean?
An out-of-province patient refers to patients with a PHN from a different province, excluding Quebec. These patients will be billed under fee-for-service (FFS).
Resources
To help you better understand and navigate the LFP payment model, we have created additional resources including:
- On-Demand Webinar: A Guide to the Longitudinal Family Physician Model
- Quick Reference Guide: LFP Payment Model
Are you unsure as to whether the LFP payment model is for you? Contact us today and we can conduct an analysis of your practice to help you determine the best path forward.
