COVID-19 Temporary MSP Billing Changes

Courtney Marie L.
March 19, 2020

Updated: March 26th, 2020

MSP has introduced temporary billing changes that allow telehealth fees to be used when the service is rendered over the telephone. These codes help reduce the spread of COVID-19 in British Columbia by keeping people at home and out of doctors’ offices, while still making sure your patients receive care. This includes services for all patients including COVID-19 patients.

For face-to-face fee codes, like consultations, office visits, and non-procedural interventions (where there is no telehealth fee available) you just have to leave a note in the notes section of the claim stating that the service was provided by video or telephone.

Furthermore, all General Practice daily volume limits have been suspended. When treating someone with services directly related to COVID-19 use diagnostic code C19.


There are also two new fee items that MSP has temporarily introduced in response to COVID-19 for face-to-face office visits.


New Fee Items relating to COVID-19 for BC Physicians

These fee codes are for in-person office visits.

T13701 Office Visit for COVID-19 with test $50

Guidelines:

  • Only payable for patients with suspected or active COVID19 symptoms.

  • COVID-19 testing must be performed.

  • Not payable for providing general information on a viral infection, including COVID-19.

  • Not payable in addition to any other office visits to the same physician for the same patient, on the same day.

T13702 Office Visit for COVID-19 without test $40.00

Guidelines:

  • Only payable for patients with suspected or active COVID-19 symptoms.

  • Not payable for providing general information on a viral infection, including COVID-19.

  • Not payable in addition to any other office visits to the same physician for the same patient, on the same day.

For more information please see the original message from Doctors of BC.


Available MSP Telehealth Codes

Allergy & Immunology

30070 Telehealth Clinical Immunology and Allergy Consultation
30071 Telehealth Pediatric Clinical Immunology and Allergy Consultation
30072 Telehealth repeat or limited Clinical Immunology and Allergy Consultation  30076 Telehealth directive care
30077 Telehealth subsequent office visit
30078 Telehealth subsequent hospital visit


Anesthesiology

01155 Telehealth Anesthesiology Consultation

Cardiac Surgery

78010 Telehealth Consultation
78012 Telehealth repeat or limited Consultation
78007 Telehealth subsequent office visit
78008 Telehealth subsequent hospital visit

Cardiology

33110 Telehealth consultation
33112 Telehealth repeat or limited consultation
33114 Telehealth prolonged visit for counseling (maximum four per year)
33106 Telehealth directive care
33107 Telehealth subsequent office visit
33108 Telehealth subsequent hospital visit

Telehealth Single Chamber permanent programmable pacemaker testing 

33126 Professional fee
33153 Technical fee


Telehealth Dual chamber permanent programmable pacemaker testing 

33128 Professional fee
33154 Technical fee


Remote Monitoring of Single chamber implantable cardiac devices

33174 Professional fee
33175 Technical fee


Remote Monitoring of Dual chamber implantable cardiac devices

33176 Professional fee
33177 Technical fee

Chest Surgery

79210 Telehealth Consultation
79212 Telehealth repeat or limited consultation
79207 Telehealth subsequent office visit
79208 Telehealth subsequent hospital visit

Critical Care

01470 Telehealth Consultation
01472 Telehealth repeat or limited consultation

Dermatology

20210 Telehealth Consultation
20214 Telehealth repeat or limited consultation
20207 Telehealth subsequent office visit
20208 Telehealth subsequent hospital visit

Emergency Medicine

No TeleHealth fee codes.

Endocrinology

33270 Telehealth Consultation
33272 Telehealth repeat or limited consultation
33276 Telehealth directive care
33277 Telehealth subsequent office visit
33278 Telehealth subsequent hospital visit
33260 Initial virtual consultation, with patient or representative/ family

33262 Repeat or limited virtual consultation within the same calendar year as 33260, where a  consultation for same illness is repeated within six months of the last visit by the consultant, or where  in the judgment of the consultant the consultative services do not warrant a full consultative fee.

33267 Subsequent virtual office visit, requiring a written individualized report to the GP 38.92  33250 Virtual communication with patient, or representative/family, for medically pertinent matters.

Gastroenterology

33360 Telehealth Consultation
33362 Telehealth repeat or limited consultation
33366 Telehealth directive care
33367 Telehealth subsequent office visit
33368 Telehealth subsequent hospital visit

General Internal Medicine

32370 Telehealth Consultation
32372 Telehealth repeat or limited consultation
32271 Telehealth Complex Consultation
32376 Telehealth directive care
32378 Telehealth subsequent hospital visit

Internal Medicine

32270 Telehealth Consultation
32272 Telehealth repeat or limited consultation
32276 Telehealth directive care
32277 Telehealth subsequent office visit
32278 Telehealth subsequent hospital visit

General Practice

13036 Telehealth GP in‐office Consultation
13037 Telehealth GP in‐office Visit (includes videos & phone-calls)
13038 Telehealth GP in‐office Individual counselling for a prolonged visit for counselling (minimum time  per visit –20 minutes, includes videos & phone-calls)

Important Reminder: Please see
the proper definitions of in-office vs. out-of office.

In-Office means the service is provided from a location other than a Health Authority site.

Out-of-Office means if you’re present in a Health Authority approved facility. The name of the facility and the results of the Telehealth service must be recorded in the patient chart.

***Therefore, if you’re at home you need to use 13036, 13037, or 13038.


Telehealth GP in‐office Group Counselling For groups of two or more patients

13041 First full hour
13042 Second hour, per ½ hour or major portion thereof
13016 Telehealth GP out‐of‐office Consultation
13017 Telehealth GP out‐of‐office visit
13018 Telehealth GP out‐of‐office Individual counselling for a prolonged visit for counselling (minimum  time per visit –20 minutes).

Telehealth GP out‐of‐office Group Counselling For groups of two or more patients

13021 First full hour
13022 Second hour, per ½ hour or major portion thereof.
13020 Telehealth General Practitioner Assistant – Physical Assessment as requested by receiving  specialist – for each 15 minutes or major portion thereof.

13501 MAiD Assessment Fee: Assessor Prescriber Includes all requirements of a MAiD assessment,  including review of medical records, patient encounter and completion of the MAiD Assessment Record  (Prescriber). The assessment may be provided either in‐person or by video conference – per 15 minutes  or greater portion thereof.

13502 MAiD Assessment Fee: Assessor Includes all requirements of a MAiD assessment, including  review of medical records, patient encounter and completion of the MAiD Assessment Record (Assessor). The assessment may be provided either in person or by video conference – per 15 minutes or  greater portion thereof.

Find the answers to frequently asked questions in response to the Telehealth codes above: Family Physicians: Answers to your frequently asked questions 

GPSC

14018 General Practice Urgent Telephone Conference with a Specialist Fee:

Conferencing on an urgent  basis (within 2 hours of request for a telephone conference) with a specialist or GP with specialty training  by telephone followed by the creation, documentation, and implementation of a clinical action plan for the care of patients with acute needs, i.e. requiring attention within the next 24 hours and  communication of that plan to the patient or patient’s representative.

14019 GP: Advice fee to a Nurse Practitioner/Midwife ‐Telephone or In person. 14077 GP: Allied Care Provider Conference Fee: per 15 minutes or greater portion thereof.
14076 GP: Patient Telephone Management Fee.
14078 GP: Email/Text/Telephone Medical Advice Relay Fee
14021 GP with Specialty Training Telephone Advice; initiated by a Specialist, General Practitioner or  Allied Care Provider, Response within 2 hours.

14022 GP with Specialty Training Telephone Advice for Patient Management; Initiated by a Specialist, General Practitioner or Allied Care Provider, Response in One Week, per 15 minutes or portion thereof.

14023 GP with Specialty Training Telephone Patient Management/Follow‐Up.

General Surgery

70070 Telehealth Consultation
70072 Telehealth repeat or limited consultation
70077 Telehealth subsequent office visit
70078 Telehealth subsequent hospital visit
70076 Telehealth directive care in emergent surgical conditions – per visit.    70080 Telehealth Complex consultation for management of malignancy.
70087 Telehealth Special office visit for new diagnosis or recurrent malignancy.

Geriatric Medicine

33470 Telehealth Consultation
33472 Telehealth repeat or limited consultation

33421
Telehealth Comprehensive geriatric consultation ‐ limited to patients aged 65 years and over.
33422 Telehealth Geriatric reassessment ‐ subsequent to comprehensive consultation ‐ limited to  patients aged 65 years and over.

33473 Telehealth Comprehensive cognitive consultation – for dementia or cognitive problems.
33474 Telehealth Geriatric reassessment subsequent to comprehensive consultation, for dementia or  cognitive problems.
33423
Telehealth Complex consultation – for 2 or more conditions.
33424 Telehealth Complex repeat or limited consultation – for 2 condition: Where a consultation for  same illness is repeated within six months of the last visit by the consultant, or where in the judgment of  the consultant the consultative services do not warrant a full consultative fee.

33476 Telehealth directive care
33426 Telehealth Comprehensive or complex directive care
33477 Telehealth subsequent office visit
33427 Telehealth Comprehensive or complex subsequent office visit
33478 Telehealth subsequent hospital visit
33428 Telehealth Comprehensive or complex subsequent hospital visit

Hematology / Medical Oncology

33570 Telehealth Consultation
33572 Telehealth repeat or limited consultation
33577 Telehealth subsequent office visit

Infectious Diseases

33630 Telehealth Consultation
33632 Telehealth Repeat or Limited Consultation
33636 Telehealth directive care
33637 Telehealth subsequent office visit
33638 Telehealth subsequent hospital visit

Laboratory Medicine

94070 Telehealth Consultation
94072 Telehealth repeat or Limited Consultation
94076 Telehealth directive care
94077 Telehealth subsequent office visit
94078 Telehealth subsequent hospital visit

Nephrology

33730 Telehealth Consultation
33732 Telehealth Repeat or Limited Consultation
33736 Telehealth directive care
33737 Telehealth subsequent office visit
33738 Telehealth subsequent hospital visit

Neurology

00470 Telehealth Consultation
00471 Telehealth Repeat or limited consultation
00476 Telehealth directive care
00477 Telehealth subsequent office visit
00478 Telehealth subsequent hospital visit
40441 Telestroke Consultation
40442 Follow‐up Telestroke neurological clinical monitoring and treatment for persisting ACVS: without  administration of tPA, per ½ hour or major portion thereof.

40443 Follow‐up Telestroke neurological clinical monitoring and treatment for persisting ACVS: with  administration of tPA, per ½ hour or major portion thereof.

40444 Follow‐up Telestroke ACVS relapse intervention, per ½ hour or major portion thereof.

Neurosurgery

03310 Telehealth Consultation
03312 Telehealth repeat or limited consultation
03317 Telehealth subsequent office visit
03318 Telehealth subsequent hospital visit   

Obstetrics & Gynecology

04070 Telehealth Consultation
04072 Telehealth repeat or limited consultation
04077 Telehealth subsequent office visit (for gynecology visits only.)
04078 Telehealth subsequent hospital visit

Occupational Medicine

No TH fees.

Ophthalmology

22010 Telehealth Consultation
22011 Telehealth repeat or limited consultation
22007 Telehealth subsequent office visit
22008 Telehealth subsequent hospital visit

Orthopaedics

No TH fees.

Otolaryngology

No TH fees.

Pediatrics

50510 Telehealth Consultation
50511 Telehealth consultation for complex behavioural, developmental or psychiatric condition in a child
50512 Telehealth repeat or limited consultation
50514 Telehealth prolonged visit for counselling
50515 Telehealth Extended Consultation – exceeding 53 minutes (actual time spent with patient).

50516 Telehealth Extended Consultation – exceeding 68 minutes (actual time spent with patient).

50517 Telehealth Complex subsequent office visit – exceeding 12 minutes (at least 10 min. spent with  patient.

50518 Telehealth Complex subsequent office visit – exceeding 23 minutes (at least 20 min. spent with patient).

50519 Telehealth Complex subsequent office visit –  exceeding 38 minutes (at least 20 min. spent with patient).

50506 Telehealth directive care
50507 Telehealth subsequent office visit
50508 Telehealth subsequent hospital visit

Physical Medicine & Rehabilitation

01770 Telehealth Formal Consultation
01772 Telehealth repeat or limited consultation: Where a formal consultation for the same illness is  repeated at an interval within six months of the last visit by the consultant
01776 Telehealth directive care
01777 Telehealth subsequent office visit
01778 Telehealth subsequent hospital visit

Plastic Surgery

66010 Telehealth Major Consultation
66012 Telehealth repeat or limited consultation
66007 Telehealth subsequent office visit
66008 Telehealth subsequent hospital visit

Psychiatry

60610 Telehealth Individual Consultation
60613 Telehealth Geriatric consultation (patients 75 years or older)
60622 Telehealth consultation: Emotionally disturbed child.


Repeat or Limited Telehealth Consultations 

60625 Telehealth–Individual consultation
60614 Telehealth–Geriatric consultation
60626 Telehealth–Emotionally disturbed child


Telehealth Psychiatric Treatment 

60607 Telehealth office visit to include services such as chemotherapy management and/or minimal  psychotherapy.
60608 Telehealth hospital in‐patient visit


Individual Telehealth Psychiatric Treatment 

60630 per 1/2 hour
60631 per 3/4 hour
60632 per 1 hour.


Family/conjoint Telehealth
Therapy: (two or more family members): 

60633 per 1/2 hour
60635 per 3/4 hour
60636 per 1 hour
60638 per 1 ¼ hour
60639 per 1 ½ hour  

60624 Telehealth clinical evaluation/interview of family member/close acquaintance/knowledgeable, professional involved in the patient’s care ‐ per 15 minutes or greater portion thereof.

60645 Telehealth Patient Management Conference ‐ meeting by specific appointment to discuss/plan patient management with third parties, including referring physicians or allied hospital staff (if an in‐ patient) or relatives, and/or community agency representatives/providers including psychologists, counsellors, case managers, home or specialty‐care nurses, social workers or other medical specialists or family practitioners – per 15 minutes or major portion thereof.

Radiology

83070 Telehealth Interventional Radiology Consultation

Respirology

32110 Telehealth Consultation
32112 Telehealth repeat or limited consultation
32114 Telehealth prolonged visit for counselling (maximum four per year).
32106 Telehealth directive care
32107 Telehealth subsequent office visit
32108 Telehealth subsequent hospital visit

Rheumatology

31110 Telehealth Consultation
31112 Telehealth Repeat or Limited Consultation
31106 Telehealth directive care
31107 Telehealth subsequent office visit
31108 Telehealth subsequent hospital visit


SSC

10001 Urgent Specialist Advice – Initiated by a Specialist, General Practitioner or Health Care  Practitioner. Verbal, real‐time response within 2 hours of the initiating physician’s or practitioner’s  request.

i) Payable for telephone, video technology or face to face communication only. Not payable for written  communication (i.e. fax, letter, email).

10002 Specialist Advice for Patient Management – Initiated by a Specialist, General Practitioner, Allied  Care Provider, or coordinator of the patient’s care. Verbal real‐time response in 7 days of initiating  request – per 15 minutes or portion thereof.

i) Payable for telephone, video technology or face‐to face communication only. Not payable for written  communication (i.e. fax, letter, email.)

10003 Specialist Patient Management / Follow‐up – per 15 minutes or portion thereof.

i) For verbal, real‐time telephone and video technology communication (including other forms of  electronic verbal communication) only. Not payable for written communication (i.e. fax, letter, e‐mail).

10005 Specialist Email Advice for Patient Management – Initiated by a Specialist, General Practitioner  or Allied Care Provider. Response within 7 days of request G10006 Specialist Email Patient Management / Follow‐up.

Urology

08070 Telehealth Consultation
08072 Telehealth repeat or limited consultation
08077 Telehealth subsequent office visit
08078 Telehealth subsequent hospital visit

Vascular Surgery

77710 Telehealth Consultation
77712 Telehealth Repeat or Limited Consultation
77707 Telehealth subsequent office visit
77708 Telehealth subsequent hospital visit


Printable version:
All Virtual Service Fee Codes (from Doctors of BC).


Preamble Rule Changes

1. The first paragraph of preamble D.1

The first paragraph of preamble D.1 is amended and now reads (bolded words have been added):

“Telehealth Service” is defined as a medical practitioner delivered health service provided to a patient through the use of video technology or telephone. “Video technology” means the recording, reproducing and broadcasting of live visual images utilizing a direct interactive video link with a patient. Services which are designated as telehealth services are payable by MSP. Consultations, office visits, and non-procedural interventions where there is no telehealth fee may be
claimed under the face-to-face fee with a claim note record that the service was provided via telehealth
. Telehealth services do not include teleradiology or tele-ultrasound, which are regulated by their specific Sectional Preambles.

For your reference, it used to read as the following (bolded words have been eliminated):


“Telehealth Service” is defined as a medical practitioner delivered health service provided to a patient via live image transmission of those images to a receiving medical practitioner at another approved site, through the use of video technology. “Video technology” means the recording, reproducing and broadcasting of live visual images utilizing a direct interactive video link with a patient. If the sending and/or receiving medical practitioner are not in a Health Authority approved site, the medical practitioner is responsible for the confidentiality and security of all records and transmissions related to the telehealth service. In order for payment to be made, the patient must be in attendance at the sending site at the time of the video capture. Only those services which are designated as telehealth services are payable by MSP. Other services/procedures require face-to-face encounters. Telehealth services do not include teleradiology or tele-ultrasound, which are regulated by their specific Sectional Preambles.

2. Eliminated the note for Daily Volume Payment Rules

Under the General practice section, the note for the daily volume amount has been eliminated, (as daily limits are suspended).

Here’s the deleted note:

screenshot2020-03-17at09-48-14-4623487

For more information on the changes please see the original message from Doctors of BC.

If, at any time, you have any questions regarding the available fee codes, or under what situation you can use them, don’t hesitate to get in touch. We’ve extended our support hours and are here to help.

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