On January 1st, 2019 the GPSC made 3 small changes that affect nearly 10 fee codes. These changes were made in a continuous effort to support more family doctors in their practice. This all stemmed in response to feedback first collected from doctors in 2017, when it was clear there wasn’t enough incentives being offered for management and planning.
The 2019 GPSC changes aim to improve access to both care and services by enabling delegation, simplifying billing, and clarifying requirements. Find a detailed explanation of how below. 👇
1. Enable Delegation and Work Better in Teams
You can now delegate non-face-to-face planning tasks to any College-Certified Allied Care Provider who is working within your practice.
You can do this for any of the following fee codes:
the Complex Care planning fees (14033, 14075);
the Palliative Care planning fee (14063)
and Mental Health planning fee (14043)
Important things to Note:
The only new change is that before you could only delegate to a provider who was employed by the practice and thus paid out of Fee-for-Service earnings. However, now, the provider can be anyone who is approved by the Health Authority.
Examples of non-face-to-face planning tasks include: chart/existing plan(s), relevant consultation notes, liaising with other providers involved in the patient’s care, blood work, medication reconciliation, etc.
You still need to do all the face-to-face planning tasks required under these fees.
2. Simplify Billing with Fee Code G14066
You are no longer required to bill a visit fee in addition to the G14066 fee code. The G14066 (Personal Health Risk Assessment) is an assessment with any patient who belongs to one of the designated health risk populations (obese, smoker, physically inactive, unhealthy eating).
This means that billing a same-day visit service is allowed, but is no longer required.
|Previous Fee Code Read:||New Fee Code Reads:|
|Visit (office or home) or CPx fee to indicate face-to-face interaction with patient or patient’s representative same day must be billed for same date of service.||Payable in addition to a visit fee (home or office) on the same day if medically required and does not take place concurrently with the face-to-face planning included under G14066.|
The change were made in order to simplify the billing process, and to align 14066 with the other GPSC Planning fees listed above in Change #1.
3. Clarifying Documentation for Mental Health Management Fees
A new fee note was added to 0120 - Counselling in Office and the Mental Health management fees (shown below) that now requires you to provide further documentation. You must include what you believe the effects of the condition are on the patient and what advice, or services, you provided. It’s suggested that you include this information in your clinical notes but it’s not necessary to provide it when entering a claim.
The exact note reads “Documentation of the effect(s) of the condition on the patient and what advice or service was provided is required.”
It’s required for the following fee codes:
G14044: GP Mental Health Management Fee age 2–49
G14045: GP Mental Health Management Fee age 50–59
G14046: GP Mental Health Management Fee age 60–69
G14047: GP Mental Health Management Fee age 70–79
G14048: GP Mental Health Management Fee age 80+
00120: Counselling in Office
If you have questions or need help figuring out when you can apply these incentives, don’t hesitate to contact our billing team today!