MSP Billing – GP Billing Update for At Risk or Complex Patients

MSP recently changed the requirements for billing code 14079 (GP Telephone/Email Management Fee).

Previously, you were only able to bill this fee code if you had billed a 14033 (Annual Complex Care Management Fee) or 14043 (GP Mental Health Planning Fee) in the past for the patient.

Now you are able to bill for this item if you have billed any of the Chronic Disease Management fee codes (14033, 14043, 14053, 14063, or 14075).

The full details of the code are listed below from MSP's payment schedule:

G14079 GP Telephone/Email Management Fee ................15.00

This fee is payable for two-way communication with eligible patients, or the patient’s medical representative, via telephone or email by the GP who has billed and been paid for at least one of the following GPSC incentives: Complex Care Planning Fee (G14033) Mental Health Planning Fee (G14043) Annual Chronic Care Bonus for COPD (G14053) Palliative Care Planning Fee (G14063) Attachment Complex Care Management Fee (G14075). This fee is billable for medical management of the conditions covered under the initial planning/Chronic Care fee. This fee is not to be billed for simple appointment reminders or referral notification.

Notes:

i) Payable to a maximum of 5 times per patient per calendar year following the successful billing of G14033, G14043, G14053, G14063 or G14075 within the previous 18 months.

ii) Telephone/Email Management requires two-way communication between the patient or the patient’s medical representative and physician or medical office staff for the purpose of medical management of the relevant chronic condition(s); it is not payable for simple notification of office or laboratory appointments or of referrals.

iii) Payable only to the physician paid for the G14033, G14043, G14053, G14063 or G14075 unless that physician has agreed to share care with another delegated physician. To facilitate payment, a note record should be submitted by the delegated physician.

iv) G14077 or G14016 payable on same day for same patient if all criteria met. Time spent on telephone with patient under this fee does not count toward the time requirement for G14077 or G14016.

v) Not payable on the same calendar day as a visit or service fee by same physician for same patient with the exception of G14077 or G14016.

vi) Not payable on same day for same patient as G14076 GP Attachment Patient Telephone Management Fee.