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Telehealth Codes for MSP Billing

Courtney Marie L.
May. 24, 2017
4-minute read
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Telehealth services are health services provided by a medical practitioner to a patient (or another medical practitioner) by video. The use of telehealth services is growing across Canada, with over 50,000 visits recorded in BC alone in 2014. You can bill MSP for providing telehealth services after giving consultations, visits or counselling via a direct, live video link with an insured patient. The following are the services that general practitioners can submit claims for (if you're a specialist, search our database here).

MSP Billing Codes for Telehealth Services (General Practice)

In-Office

13036 – Consultation 13037 – Visit 13038 – Individual counselling for a prolonged visit Group Counselling (For groups of two or more patients) 13041 – First full hour 13042 – Second hour, per ½ hour  

Out-of-Office

*For out-of-office services, the physician providing the service must be physically present in a Health Authority approved facility. 13016 – Consultation 13017 – Visit 13018 – Individual counselling for a prolonged visit 13020 – Telehealth General Practitioner Assistant Group Counselling (For groups of two or more patients) 13021 – First full hour 13022 – Second hour, per ½ hour

Pre-amble Rules and Notes

  • 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 are payable only when provided to a patient with valid medical coverage. Patients must be informed and given opportunity to agree to services rendered using this modality.
  • In those cases where a specialist service requires a general practitioner at the patient’s site to assist with the essential physical assessment, without which the specialist service would be ineffective, the specialist must indicate in the "Referred by" field that a request was made for a General Practice assisted assessment.
  • Where a receiving medical practitioner, after having provided a telehealth consultation service to a patient, decides s/he must examine the patient in person, the medical practitioner should claim the subsequent visit as a limited consultation, unless more than 6 months has passed since the telehealth consultation.
  • Where a telehealth service is interrupted for technical failure, and is not able to be resumed within a reasonable period of time, and therefore is unable to be completed, the receiving medical practitioner should submit a claim under the appropriate miscellaneous code for independent consideration with appropriate substantiating information.
  • Video technology services are generally payable once per patient/per day/per medical practitioner.
  • Compensation for travel, scheduling and other logistics is the responsibility of the Regional Health Authority. Rural Retention fee-for-service premiums are applicable to telehealth services and are payable based on the location of the receiving medical practitioner in eligible RSA communities.
  • BC medical practitioners providing care via telehealth to patients outside the province must abide by the regulations set in the patient’s home province.
  This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
I had nearly 50% of my submissions rejected, but Dr. Bill conveniently followed up on them for me. It’s the most user-friendly service I have come across.
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Courtney Marie L
Writer and editor with a demonstrated history of working in the Canadian healthcare sector and the publishing industry. Skilled in writing, editing, proofreading, Spanish to English translation, and teaching English as a second language. Strong communications professional with a Bachelor of Arts in Geography and Political Science from the University of Manitoba.
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