New and Upcoming Changes to the MSP Billing Claims

The Ministry of Health and Health Insurance BC announced changes to the way doctors must submit their MSP billing claims. In this blog post, we share the latest updates to help prepare you for the upcoming changes. 

Service Location Codes (SLC) 

Effective April 1, 2021, Service Location A for MSP practitioner claims will be replaced with new codes. This will allow the Ministry of Health to collect data related to service locations in greater detail.  

There are nine new Service Location Codes:  

Service Location Code   Description  Who should bill  
(B) Community Health Centre  Interprofessional primary care that integrates services/programs in primary care, health promotion, and community well-being including primary care services as well as a broader range of social supports.  If you are providing care in a community health centre that integrates primary care services as well as a broader range of social support.  
(K) Hybrid Primary Care Practice   Part time longitudinal primary care practice, part-time walk-in clinic (see definitions below).  If you are providing care in a part-time private practice/part-time walk-in clinic.  
(J) First Nations Primary Health Care Clinic   Provides interprofessional based continuum of care that integrates health services, disease prevention and management, population health promotion, traditional and mental wellness, and social determinants of health, as well as embodies attributes of cultural safety and humility, trauma-informed care, and integration to first nations communities.  If you are working in a primary health care clinic providing inter-professional-based care to first nations communities. 
(L) Longitudinal Primary Care Practice  A Family Physician, group of Family Physicians, or group of primary care providers (FPs and NPs), practicing in a private longitudinal primary care practice (e.g. Patient Medical Home).  If you are providing care in a private practice or with other primary care providers. 
(N) Health Care Practitioner Office  An office where non-physician Health Care Practitioners, e.g. Nurse Practitioners, are providing primary care.  If you are working in a private practice (e.g. midwives, supplementary benefit providers) are providing services billed to or tracked through MSP. 
(Q) Specialist Physician Office  A specialist physician office.  If you are providing care as a specialist physician working in a private specialized medical practice. 
(U) Urgent and Primary Care Centre  Provides longitudinal full-service primary care and attachment in addition to meeting the episodic urgent primary care needs for both attached and unattached patients  If you work in a primary care centre that provides care for both attached and unattached patients. 
(V) Virtual Care Exclusive  Method of delivering health care diagnosis and treatment services is via virtual care. Does not include other clinics or centers where virtual care is provided in addition to in-person care (e.g. a Longitudinal Primary Care Practice offering virtual care services would not use V).  If you are providing care for an exclusively virtual care clinic practice. 
(W) Walk-In Clinic  Provides same day, non-emergency Family Physician care without an appointment.  If you are providing care in a walk-in clinic. 

Service Location Code A will continue to be valid from April 1, 2021, to September 30, 2021. Claims submitted with Service Location Code A for services provided after September 30, 2021, will be refused. We recommend physicians start familiarizing themselves with the new codes now so that it will be easier to adjust in October. 

Practitioners should consult with their Teleplan vendors to ensure that required changes to the Service Location Code field are completed on time and in accordance with updated Teleplan specifications. 

Practitioner and Payee Numbers Value for MSP billing claims 

The MOH and HIBC have determined that the available practitioner and payee numbers will be depleted by 2023. Practitioner and payee numbers are currently defined throughout the MSP Claims system as a five character field with values ranging from 00000 to 99999. Once the existing pool of numbers are depleted, it will no longer be possible to register new practitioners in BC. 

To combat the decreasing supply of practitioner and payee numbers, the Ministry is issuing new numbers starting April 1, 2022, with alphanumeric values. The number of characters in practitioner and payee numbers (five) will remain unchanged, and numbers issued before April 1, 2022, will remain valid. 

Current Teleplan specifications require the practitioner and payee number to be in character format. Teleplan vendors whose code limits the field to numeric characters, or whose system logic depends on a numeric-only value, must reconfigure their software to accept alphanumeric values by April 1, 2022. 

If you have any questions about how these changes affect you, please contact us! 

 

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