General practice MSP billing codes


Consultations

Code Description Amount
00110 IN OFFICE: AGE 2-49-CONSULTATION $74.31
00116 SPECIAL IN-HOSPITAL, CONSULTATION $158.78
12110 IN OFFICE:(AGE 0-1)-CONSULTATION $81.75
12210 OUT OF OFFICE (AGE 0-1)-CONSULTATION $98.10
13210 OUT OF OFFICE (AGE 2-49)-CONSULTATION $89.18
15210 OUT OF OFFICE (AGE 50-59)-CONSULTATION $98.10
15310 IN OFFICE (AGE 50-59)-CONSULTATION $81.75
16110 IN OFFICE:(AGE 60-69)-CONSULTATION $85.45
16210 OUT OF OFFICE (AGE 60-69)-CONSULTATION $102.56
17110 IN OFFICE: (AGE 70-79)-CONSULTATION $96.60
17210 OUT OF OFFICE (AGE 70-79)-CONSULTATION $115.93
18110 IN OFFICE: (AGE 80+)-CONSULTATION $111.47
18210 OUT OF OFFICE (AGE 80+)-CONSULTATION $133.77

Complete Examinations

Code Description Amount
00101 IN OFFICE (AGE 2-49)-COMPLETE EXAMINATION $67.61
12101 IN OFFICE (AGE 0-1)-COMPLETE EXAMINATION $74.37
12201 OUT OF OFFICE (AGE 0-1)-COMPLETE EXAMINATION $89.25
13201 OUT OF OFFICE (AGE 2-49)-COMPLETE EXAMINATION $81.14
15201 OUT OF OFFICE (AGE 50-59)-COMPLETE EXAMINATION $89.25
15301 IN OFFICE (AGE 50-59)-COMPLETE EXAMINATION $74.37
16101 IN OFFICE (AGE 60-69)-COMPLETE EXAMINATION $77.76
16201 OUT OF OFFICE (AGE 60-69)-COMPLETE EXAMINATION $93.31
17101 IN OFFICE (AGE 70-79)-COMPLETE EXAMINATION $88.12
17201 OUT OF OFFICE (AGE 70-79)-COMPLETE EXAMINATION $105.75
18101 IN OFFICE (AGE 80+)-COMPLETE EXAMINATION $101.42
18201 OUT OF OFFICE (AGE 80+)-COMPLETE EXAMINATION $121.71

Visits

Code Description Amount
00100 VISIT IN OFFICE (AGE 2 - 49) $30.46
00105 ON CALL, ON SITE HOSPITAL VISIT - NIGHT $70.35
00111 VISIT, EMERGENCY HOME $113.43
00112 VISIT, EMERGENCY $113.15
00113 ON CALL, ON SITE HOSPITAL VISIT - EVENING $50.62
00123 ON CALL, ON SITE HOSPITAL VISIT - SAT, SUN OR HOLS $50.14
12100 VISIT IN OFFICE (AGE 0-1) $33.50
12200 VISIT - OUT OF OFFICE (AGE 0 - 1) $40.20
13070 IN OFFICE ASSESSMENT IN ASSOC WITH A WSBC SERVICE $15.83
13075 IN OFFICE ASSESSMENT IN ASSOC WITH AN ICBC SERVICE $15.83
13200 VISIT - OUT OF OFFICE (AGE 2-49) $36.54
15200 VISIT OUT OF OFFICE (AGE 50-59) $40.20
15300 VISIT IN OFFICE (AGE 50-59) $33.50
16100 VISIT IN OFFICE (AGE 60-69) $35.03
16200 VISIT - OUT OF OFFICE (AGE 60-69) $42.03
17100 VISIT IN OFFICE (AGE 70-79) $39.60
17200 VISIT - OUT OF OFFICE (AGE 70-79) $47.51
18100 VISIT IN OFFICE (AGE 80+) $45.68
18200 VISIT - OUT OF OFFICE (AGE 80+) $54.83

Group Medical Visits

Code Description Amount
13763 GENERAL PRACTICE GROUP MEDICAL VISIT - 3 PATIENTS $24.91
13764 GENERAL PRACTICE GROUP MEDICAL VISIT - 4 PATIENTS $20.13
13765 GENERAL PRACTICE GROUP MEDICAL VISIT - 5 PATIENTS $17.29
13766 GENERAL PRACTICE GROUP MEDICAL VISIT - 6 PATIENTS $15.39
13767 GENERAL PRACTICE GROUP MEDICAL VISIT - 7 PATIENTS $14.03
13768 GENERAL PRACTICE GROUP MEDICAL VISIT - 8 PATIENTS $13.02
13769 GENERAL PRACTICE GROUP MEDICAL VISIT - 9 PATIENTS $12.21
13770 GENERAL PRACTICE GROUP MEDICAL VISIT - 10 PATIENTS $11.57
13771 GENERAL PRACTICE GROUP MEDICAL VISIT - 11 PATIENTS $10.14
13772 GENERAL PRACTICE GROUP MEDICAL VISIT - 12 PATIENTS $9.53
13773 GENERAL PRACTICE GROUP MEDICAL VISIT - 13 PATIENTS $8.83
13774 GENERAL PRACTICE GROUP MEDICAL VISIT - 14 PATIENTS $8.67
13775 GENERAL PRACTICE GROUP MEDICAL VISIT - 15 PATIENTS $8.32
13776 GENERAL PRACTICE GROUP MEDICAL VISIT - 16 PATIENTS $8.07
13777 GENERAL PRACTICE GROUP MEDICAL VISIT - 17 PATIENTS $7.73
13778 GENERAL PRACTICE GROUP MEDICAL VISIT - 18 PATIENTS $7.55
13779 GENERAL PRACTICE GROUP MEDICAL VISIT - 19 PATIENTS $7.29
13780 GENERAL PRACTICE GROUP MEDICAL VISIT - 20 PATIENTS $7.12
13781 GENERAL PRACTICE GROUP MEDICAL VISIT- >20 PATIENTS $6.86

Counselling Individual

Code Description Amount
00120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 2-49) $53.50
12120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) $58.29
12220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 0 - 1) $69.95
13220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 2-49) $63.59
15220 INDIVIDUAL COUNSELLING OUT OF OFFICE (AGE 50-59) $69.95
15320 INDIVIDUAL COUNSELLING IN OFFICE (AGE 50-59) $58.29
16120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 60 - 69) $60.94
16220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 60-69) $73.13
17120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) $68.90
17220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 70-79) $82.68
18120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) $79.50
18220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 80 +) $95.40

Counselling Group

Code Description Amount
00121 GROUP COUNSELLING-FIRST FULL HOUR $86.16
00122 GROUP COUNSELLING-2ND HOUR/PER HALF OR MAJOR PART $43.11

Facility Visits

Code Description Amount
00108 HOSPITAL VISIT $31.45
00109 ACUTE CARE HOSPITAL ADMISSION VISIT $80.40
00114 VISIT NURSING HOME ONE OR MULTIPLE PATIENTS $33.18
00115 NURSING HOME VISIT - 1 PATIENT WHEN SPECIALLY CALL $112.53
00127 TERMINAL CARE FACILITY VISIT $51.80
00128 SUPPORTIVE CARE HOSPITAL VISIT $26.63
13334 LTC FACILITY VISIT-FIRST VISIT OF DAY BONUS,EXTRA $32.96

Community Based Gp Hospital Visits

Code Description Amount
13008 COMMUNITY BASED GP: HOSPITAL VISIT $51.80
13028 COMMUNITY BASED GP: SUPPORTIVE CARE HOSP VISIT $34.87
13228 COMMUNITY BASED GP: HOSPITAL VISIT $28.89
13338 COMMUNITY BASED GP,1ST FAC VISIT OF DAY BONUS,EXTR $36.34
13339 COM BASED GP,1ST HOSP VISIT OF DAY BONUS, EXTRA $28.89

Phone Calls & Email

Code Description Amount
13005 Phone Call (Advice about patient in Community Care) $15.23
13000 TELEPHONE ADVICE IN FIRST NATIONS COMMUNITIES $15.21
14018 GP URGENT TELEPHONE CONFERENCE WITH A SPECIALIST $40.00
14021 GP WITH SPECIALTY TRAINING TELE ADVICE - URGENT $60.00
14022 GP WITH SPECIALTY TRAINING TELE PATIENT MGMT 1 WK $40.00
14023 GP WITH SPEC TRAINING TELE PATIENT MGMT-FOLLOW UP $20.00
14079 GP TELEPHONE/EMAIL MANAGEMENT FEE $15.00

Gynecology & Pregnancy

Code Description Amount
00118 CAESAREAN SECTION-ATTENDANCE $87.43
00119 NEWBORN CARE, ROUTINE, IN HOSPITAL $89.38
14004 FULL SERVICE GP-OBSTET DELIVERY BONUS-W DELIVERY $280.25
14005 FULL SERVICE GP-BONUS WITH TRANSFER HIGHER CARE $116.71
14008 FULL SERVICE GP-BONUS WITH POST NATAL CARE $57.66
14009 FULL SERVICE GP-OBSTET DELIVERY BONUS-W C SECTION $233.44
14090 PRENATAL VISIT- COMPLETE EXAMINATION $81.31
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $30.46
14094 POST-NATAL OFFICE VISIT $30.46
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $563.02
14105 MANAGEMENT OF LABOUR AND TRANSFER TO HIGHER LEVEL $234.47
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $115.83
14109 DELIVERY - ATTENDANCE - EMERG C/S $468.97
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $82.27
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $41.54
14545 MEDICAL ABORTION $158.82
14560 ROUTINE PELVIC EXAM INCLUDING PAP $30.46
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.19
14010 Maternity Network Incentive $2,100.00

Surgical Assistance

Code Description Amount
00193 NON-CVT CERT. SURGICAL ASSIST @ OPEN HEART SURGERY $29.07
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $132.23
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $186.43
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $246.57
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.93
13052 ANAES. EVALUATION - NON-CERTIFIED ANAESTHETIST $39.60
13194 GP FIRST SURGICAL ASSIST OF THE DAY $81.90

Procedures

Code Description Amount
00190 ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. $30.30
10710 IN-OFFICE ANOSCOPY $7.68
13600 BIOPSY - MUCOSA/SKIN (OPERATION ONLY) $50.29
13601 BIOPSY - FACIAL AREA (OPERATION ONLY) $50.29
13605 ABSCESS - SUPERFICIAL $43.08
13610 MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA $34.50
13611 MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. $64.26
13612 EXTENSIVE LACERATION GREATER THAN 5CM $12.89
13620 EXCISION TUMOR OF SKIN/SCAR UP TO 5CM $64.26
13621 EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM $32.13
13622 LOCALIZED CARCINOMA OF SKIN PROVEN HISTOPATH. $70.99
13630 PARONYCHIA $34.41
13631 NAIL REMOVAL - SIMPLE $34.41
13632 NAIL REMOVAL WITH DESTRUCTION OF NAIL BED $69.63
13633 WEDGE EXCISION OF ONE NAIL $61.43
13650 ENUCLEATION OR EXCISION OF EXT THROMBOTIC HAEMORRH $50.48
13660 METATARSAL BONE - CLOSED REDUCTION $51.11

Laboratory Services

Code Description Amount
00012 INJECTION, VENEPUNCTURE $5.74
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.58
15100 GLUCOSE - SEMIQUANTITATIVE $3.61
15110 OCCULT BLOOD - FECES $5.23
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.19
15130 URINALYSIS - SCREENING $2.09
15131 URINALYSIS - MICRO EXAM OF CENTRIFUGED DEPOSIT $4.04
15132 CANDIDA CULTURE (IN PHYSICIANS OFFICE) $6.57
15133 EXAMINATION OF EOSINOPHILS/SECRETIONS/EXCRETIONS $7.04
15134 PINWORM OVA-EXAMINATION $5.79
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.27
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.08
15138 SEDIMENTATION RATE (IN PHYSICIANS OFFICE) $2.47
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.56
15140 STAINED SMEAR (IN PHYSICIANS OFFICE) $7.28
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.54
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.42
15143 WHITE CELL COUNT ONLY $6.38
30015 EOSINOPHILS - SECRETION SMEAR $7.18
93120 E.C.G. TRACING, WITHOUT INTERPRETATION (TECHNICAL) $16.39

Gpsc Annual Bonuses

Code Description Amount
14033 ANNUAL COMPLEX CARE MANAGEMENT FEE $315.00
14050 GP ANNUAL CHRONIC CARE BONUS - DIABETES MELLITUS $125.00
14051 GP ANNUAL CHRONIC CARE BONUS - HEART FAILURE $125.00
14052 GP ANNUAL CHRONIC CARE BONUS - HYPERTENSION $50.00
14053 INCENTIVE FOR GP ANNUAL CHRONIC CARE BONUS COPD $125.00

Conferences

Code Description Amount
14015 FACILITY PATIENT CONFERENCE-GENERAL PRACTICE $40.00
14016 COMMUNITY PATIENT CONFERENCE FEE-GENERAL PRACTICE $40.00
14017 GENERAL PRACTICE ACUTE CARE DISCHARGE CONFERENCE $40.00

Mental Health Planning & Management

Code Description Amount
14043 GP MENTAL HEALTH PLANNING FEE $100.00
14044 GP MENTAL HEALTH MANAGEMENT FEE AGE 2-49 $52.76
14045 GP MENTAL HEALTH MANAGEMENT FEE AGE 50-59 $58.03
14046 GP MENTAL HEALTH MANAGEMENT FEE AGE 60-69 $60.67
14047 GP MENTAL HEALTH MANAGEMENT FEE AGE 70-79 $68.59
14048 GP MENTAL HEALTH MANAGEMENT FEE AGE 80+ $79.14

Gp For Me Attachment Fees

Code Description Amount
14070 GP ATTACHMENT PARTICIPATION $0.00
14071 GP LOCUM ATTACHMENT PARTICIPATION $0.00
14074 GP UNATTACHED COMPLEX/HIGH NEEDS PATIENT ATTACHMEN $200.00
14075 GP ATTACHMENT COMPLEX CARE MANAGEMENT FEE $315.00
14076 GP ATTACHMENT TELEPHONE MANAGEMENT FEE $15.00
14077 GP ATTACHMENT PATIENT CONFERENCE FEE $40.00

Other Gpsc Fees

Code Description Amount
14063 PALLIATIVE CARE PLANNING FEE-GENERAL PRACTICE $100.00
14066 PERSONAL HEALTH RISK ASSESSMENT $50.00
14086 GP ASSIGNED INPATIENT CARE NETWORK $2,100.00
14088 GP UNASSIGNED INPATIENT CARE FEE $150.00

Other

Code Description Amount
13036 TELEHEALTH GP IN-OFFICE CONSULTATION $80.73
13037 TELEHEALTH GP IN-OFFICE VISIT $33.71
13038 TELEHEALTH GP IN-OFFICE INDIVIDUAL COUNSELLING $57.68
13041 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING/1ST HR $85.13
13042 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING - 2ND HR $42.60
13016 TELEHEALTH GP OUT OF OFFICE CONSULTATION $107.40
13017 TELEHEALTH GP OUT OF OFFICE VISIT $40.49
13018 TELEHEALTH GP OUT OF OFFICE INDIVIDUAL COUNSELLING $74.20
13021 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 1ST HOUR $86.16
13022 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 2ND HOUR $43.11
13020 TELEHEALTH GENERAL PRACTITIONER ASSISTANT $30.46
13015 HIV/AIDS PRIMARY CARE MGMT - PER 1/2 HR OR $84.16
00103 HOME VISIT - CALL PLACED BETWEEN 0800 AND 2300HRS $113.15
13655 GENERAL PRACTICE - VASECTOMY BONUS $20.65
00117 ECG INTERPRETATION ONLY G.P. $9.99
03333 NO CHARGE REFERRAL $0.00