The GSPC has announced two new MSP billing fee codes to help support family doctors providing longitudinal and team-based care; these include the Brief Clinical Conference Fee (14067) and the CLFP New Patient Intake Fee (14041). The new fee codes can be billed for services provided on or after October 1, 2021. In this blog, we will share the latest update on the new codes and provide the resources you need to accurately bill them.
Brief Clinical Conference Fee (14067)
The Brief Clinical Conference Fee is payable for two-way case conferencing about a patient with at least one Allied Care Provider (ACP) and/or physician. This fee is billable regardless of where the patient is located or how the conference occurs and has no minimum time requirement. This fee code is payable to a maximum of one per patient per day with a maximum of 150 per physician per calendar year.
|PH14067||FP Brief Clinical Conference with Allied Care Provider and/or Physician||$18.22|
The PH1067 fee code is eligible to the family doctor who is most responsible for the patient’s longitudinal primary care and has submitted and met one of the requirements below:
- Community longitudinal family physician (CLFP) portal code (14070)
- Locum CLFP code (14071)
- Long-term care portal code (14072)
- Registered in GPSC maternity care network or a GPSC unassigned in=patient network
MSP Billing Requirements
- Documentation in the patient’s chart is required.
- Conferencing cannot be delegated.
- Not payable in addition to PG14077 or PG14018.
- Not payable to physicians working under an Alternative Payment/Funding model whose duties would otherwise include provision of this service.
- Not payable for situations where the purpose of the call is to:
- book an appointment
- arrange for laboratory or diagnostic investigations
- convey the results of diagnostic investigations; d. arrange a hospital bed for a patient
When to Bill MSP Billing Fee Codes 13005 and 14077
We have heard that there’s been a lot of confusion about the new fee code 14067 and when to bill it versus the fee codes 13005 and 14077, as they are quite similar. In the following section, we share some information on when it’s necessary to bill the fee codes 13005 or 14077.
Please note, the fee code 14067 should not be billed for conferencing activities that can be billed as fee codes 13005 or PG14077.
Advice About a Patient in Community Care (13005)
The fee code 13005 can be billed for advice by telephone, fax, or in written form about a patient in community care given in response to an enquiry initiated by an allied health care worker.
|13005||Advice About a Patient in Community Care||$18.22|
Conference with Allied Provider and/or Physician (14077)
The fee code 14077 can be billed for two-way conferencing about a patient with at least one allied care provider or physician per 15 minutes or greater portion thereof.
|14077||Conference with Allied Provider and/or Physician – per 15 minutes or greater portion thereof||$40|
CLFP New Patient Intake Fee (14041)
THE CLFP New Patient Intake Fee is payable in addition to a visit fee for confirming the addition of a new patient to the physician’s panel where the longitudinal doctor-patient relationship has been confirmed through a standardized conversation or ‘compact’. By billing the fee code 14041, the FP commits to assuming the role of Most Responsible Provider (MRP) for the patient. The fee code is payable to a maximum of one per patient per calendar year.
|14041||CLFP New Patient Intake Fee||$15|
MSP Billing Requirements
- Must be billed within the first three months of the MRP onboarding the new patient into their ongoing care.
- A visit must have been provided by the billing physician on the same day or within three months prior to the billing the fee code 14041.
- Not payable to physicians working under an Alternative Payment/Funding model which is inclusive of the activities included in this fee.
- Not payable to locum physicians.
Note: Fee code 14041 must be billed within the first three months of intake so new patients whose first visit was no earlier than July 1, 2021 are eligible.
DoctorCare helps doctors sort through confusing billing rules, automate billing submissions, ensure errors are fixed, and optimize billings to maximize revenue. If you are interested in learning more about how we can help, contact us to set up a free consultation.