General practice MSP billing codes


Consultations

Code Description Amount
00110 IN OFFICE: AGE 2-49-CONSULTATION $73.98
00116 SPECIAL IN-HOSPITAL, CONSULTATION $158.78
12110 IN OFFICE:(AGE 0-1)-CONSULTATION $81.38
12210 OUT OF OFFICE (AGE 0-1)-CONSULTATION $97.66
13210 OUT OF OFFICE (AGE 2-49)-CONSULTATION $88.78
15210 OUT OF OFFICE (AGE 50-59)-CONSULTATION $97.66
15310 IN OFFICE (AGE 50-59)-CONSULTATION $81.38
16110 IN OFFICE:(AGE 60-69)-CONSULTATION $85.07
16210 OUT OF OFFICE (AGE 60-69)-CONSULTATION $102.10
17110 IN OFFICE: (AGE 70-79)-CONSULTATION $96.17
17210 OUT OF OFFICE (AGE 70-79)-CONSULTATION $115.41
18110 IN OFFICE: (AGE 80+)-CONSULTATION $110.97
18210 OUT OF OFFICE (AGE 80+)-CONSULTATION $133.17

Complete Examinations

Code Description Amount
00101 IN OFFICE (AGE 2-49)-COMPLETE EXAMINATION $67.31
12101 IN OFFICE (AGE 0-1)-COMPLETE EXAMINATION $74.04
12201 OUT OF OFFICE (AGE 0-1)-COMPLETE EXAMINATION $88.85
13201 OUT OF OFFICE (AGE 2-49)-COMPLETE EXAMINATION $80.78
15201 OUT OF OFFICE (AGE 50-59)-COMPLETE EXAMINATION $88.85
15301 IN OFFICE (AGE 50-59)-COMPLETE EXAMINATION $74.04
16101 IN OFFICE (AGE 60-69)-COMPLETE EXAMINATION $77.41
16201 OUT OF OFFICE (AGE 60-69)-COMPLETE EXAMINATION $92.89
17101 IN OFFICE (AGE 70-79)-COMPLETE EXAMINATION $87.73
17201 OUT OF OFFICE (AGE 70-79)-COMPLETE EXAMINATION $105.28
18101 IN OFFICE (AGE 80+)-COMPLETE EXAMINATION $100.97
18201 OUT OF OFFICE (AGE 80+)-COMPLETE EXAMINATION $121.16

Visits

Code Description Amount
00100 VISIT IN OFFICE (AGE 2 - 49) $30.32
00105 ON CALL, ON SITE HOSPITAL VISIT - NIGHT $69.79
00111 VISIT, EMERGENCY HOME $112.92
00112 VISIT, EMERGENCY $110.97
00113 ON CALL, ON SITE HOSPITAL VISIT - EVENING $49.62
00123 ON CALL, ON SITE HOSPITAL VISIT - SAT, SUN OR HOLS $49.62
12100 VISIT IN OFFICE (AGE 0-1) $33.35
12200 VISIT - OUT OF OFFICE (AGE 0 - 1) $40.02
13070 IN OFFICE ASSESSMENT IN ASSOC WITH A WSBC SERVICE $15.76
13075 IN OFFICE ASSESSMENT IN ASSOC WITH AN ICBC SERVICE $15.76
13200 VISIT - OUT OF OFFICE (AGE 2-49) $36.38
15200 VISIT OUT OF OFFICE (AGE 50-59) $40.02
15300 VISIT IN OFFICE (AGE 50-59) $33.35
16100 VISIT IN OFFICE (AGE 60-69) $34.87
16200 VISIT - OUT OF OFFICE (AGE 60-69) $41.84
17100 VISIT IN OFFICE (AGE 70-79) $39.42
17200 VISIT - OUT OF OFFICE (AGE 70-79) $47.30
18100 VISIT IN OFFICE (AGE 80+) $45.48
18200 VISIT - OUT OF OFFICE (AGE 80+) $54.58

Group Medical Visits

Code Description Amount
13763 GENERAL PRACTICE GROUP MEDICAL VISIT - 3 PATIENTS $24.80
13764 GENERAL PRACTICE GROUP MEDICAL VISIT - 4 PATIENTS $20.04
13765 GENERAL PRACTICE GROUP MEDICAL VISIT - 5 PATIENTS $17.21
13766 GENERAL PRACTICE GROUP MEDICAL VISIT - 6 PATIENTS $15.32
13767 GENERAL PRACTICE GROUP MEDICAL VISIT - 7 PATIENTS $13.97
13768 GENERAL PRACTICE GROUP MEDICAL VISIT - 8 PATIENTS $12.96
13769 GENERAL PRACTICE GROUP MEDICAL VISIT - 9 PATIENTS $12.16
13770 GENERAL PRACTICE GROUP MEDICAL VISIT - 10 PATIENTS $11.52
13771 GENERAL PRACTICE GROUP MEDICAL VISIT - 11 PATIENTS $10.09
13772 GENERAL PRACTICE GROUP MEDICAL VISIT - 12 PATIENTS $9.49
13773 GENERAL PRACTICE GROUP MEDICAL VISIT - 13 PATIENTS $8.79
13774 GENERAL PRACTICE GROUP MEDICAL VISIT - 14 PATIENTS $8.63
13775 GENERAL PRACTICE GROUP MEDICAL VISIT - 15 PATIENTS $8.28
13776 GENERAL PRACTICE GROUP MEDICAL VISIT - 16 PATIENTS $8.03
13777 GENERAL PRACTICE GROUP MEDICAL VISIT - 17 PATIENTS $7.70
13778 GENERAL PRACTICE GROUP MEDICAL VISIT - 18 PATIENTS $7.52
13779 GENERAL PRACTICE GROUP MEDICAL VISIT - 19 PATIENTS $7.26
13780 GENERAL PRACTICE GROUP MEDICAL VISIT - 20 PATIENTS $7.09
13781 GENERAL PRACTICE GROUP MEDICAL VISIT- >20 PATIENTS $6.83

Counselling Individual

Code Description Amount
00120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 2-49) $52.76
12120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) $58.03
12220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 0 - 1) $69.64
13220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 2-49) $63.31
15220 INDIVIDUAL COUNSELLING OUT OF OFFICE (AGE 50-59) $69.64
15320 INDIVIDUAL COUNSELLING IN OFFICE (AGE 50-59) $58.03
16120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 60 - 69) $60.67
16220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 60-69) $72.80
17120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) $68.59
17220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 70-79) $82.31
18120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) $79.14
18220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 80 +) $94.97

Counselling Group

Code Description Amount
00121 GROUP COUNSELLING-FIRST FULL HOUR $85.77
00122 GROUP COUNSELLING-2ND HOUR/PER HALF OR MAJOR PART $42.92

Facility Visits

Code Description Amount
00108 HOSPITAL VISIT $31.31
00109 ACUTE CARE HOSPITAL ADMISSION VISIT $80.04
00114 VISIT NURSING HOME ONE OR MULTIPLE PATIENTS $33.03
00115 NURSING HOME VISIT - 1 PATIENT WHEN SPECIALLY CALL $110.97
00127 TERMINAL CARE FACILITY VISIT $51.61
00128 SUPPORTIVE CARE HOSPITAL VISIT $26.51
13334 LTC FACILITY VISIT-FIRST VISIT OF DAY BONUS,EXTRA $32.81

Community Based Gp Hospital Visits

Code Description Amount
13008 COMMUNITY BASED GP: HOSPITAL VISIT $51.61
13028 COMMUNITY BASED GP: SUPPORTIVE CARE HOSP VISIT $34.71
13228 COMMUNITY BASED GP: HOSPITAL VISIT $28.76
13338 COMMUNITY BASED GP,1ST FAC VISIT OF DAY BONUS,EXTR $36.18
13339 COM BASED GP,1ST HOSP VISIT OF DAY BONUS, EXTRA $28.76

Phone Calls & Email

Code Description Amount
13005 Phone Call (Advice about patient in Community Care) $15.16
13000 TELEPHONE ADVICE IN FIRST NATIONS COMMUNITIES $15.14
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 $87.04
00119 NEWBORN CARE, ROUTINE, IN HOSPITAL $88.98
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 $80.95
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $30.32
14094 POST-NATAL OFFICE VISIT $30.32
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $560.50
14105 MANAGEMENT OF LABOUR AND TRANSFER TO HIGHER LEVEL $233.42
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $115.31
14109 DELIVERY - ATTENDANCE - EMERG C/S $466.87
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $81.41
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $41.35
14545 MEDICAL ABORTION $158.11
14560 ROUTINE PELVIC EXAM INCLUDING PAP $30.32
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.14
14010 Maternity Network Incentive $2,100.00

Surgical Assistance

Code Description Amount
00193 NON-CVT CERT. SURGICAL ASSIST @ OPEN HEART SURGERY $28.39
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $131.64
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $185.59
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $245.47
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.80
13052 ANAES. EVALUATION - NON-CERTIFIED ANAESTHETIST $39.42
13194 GP FIRST SURGICAL ASSIST OF THE DAY $81.53

Procedures

Code Description Amount
00190 ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. $29.99
10710 IN-OFFICE ANOSCOPY $7.60
13600 BIOPSY - MUCOSA/SKIN (OPERATION ONLY) $49.77
13601 BIOPSY - FACIAL AREA (OPERATION ONLY) $49.77
13605 ABSCESS - SUPERFICIAL $42.63
13610 MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA $34.15
13611 MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. $63.59
13612 EXTENSIVE LACERATION GREATER THAN 5CM $12.75
13620 EXCISION TUMOR OF SKIN/SCAR UP TO 5CM $64.26
13621 EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM $31.80
13622 LOCALIZED CARCINOMA OF SKIN PROVEN HISTOPATH. $70.25
13630 PARONYCHIA $34.06
13631 NAIL REMOVAL - SIMPLE $34.06
13632 NAIL REMOVAL WITH DESTRUCTION OF NAIL BED $68.91
13633 WEDGE EXCISION OF ONE NAIL $60.80
13650 ENUCLEATION OR EXCISION OF EXT THROMBOTIC HAEMORRH $49.96
13660 METATARSAL BONE - CLOSED REDUCTION $50.58

Laboratory Services

Code Description Amount
00012 INJECTION, VENEPUNCTURE $5.71
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.57
15100 GLUCOSE - SEMIQUANTITATIVE $3.59
15110 OCCULT BLOOD - FECES $5.21
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.14
15130 URINALYSIS - SCREENING $2.08
15131 URINALYSIS - MICRO EXAM OF CENTRIFUGED DEPOSIT $4.02
15132 CANDIDA CULTURE (IN PHYSICIANS OFFICE) $6.54
15133 EXAMINATION OF EOSINOPHILS/SECRETIONS/EXCRETIONS $7.01
15134 PINWORM OVA-EXAMINATION $5.76
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.23
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.07
15138 SEDIMENTATION RATE (IN PHYSICIANS OFFICE) $2.46
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.49
15140 STAINED SMEAR (IN PHYSICIANS OFFICE) $7.25
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.52
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.40
15143 WHITE CELL COUNT ONLY $6.35
30015 EOSINOPHILS - SECRETION SMEAR $7.15
93120 E.C.G. TRACING, WITHOUT INTERPRETATION (TECHNICAL) $16.45

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 $80.37
13037 TELEHEALTH GP IN-OFFICE VISIT $33.56
13038 TELEHEALTH GP IN-OFFICE INDIVIDUAL COUNSELLING $57.42
13041 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING/1ST HR $84.75
13042 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING - 2ND HR $42.41
13016 TELEHEALTH GP OUT OF OFFICE CONSULTATION $106.92
13017 TELEHEALTH GP OUT OF OFFICE VISIT $40.31
13018 TELEHEALTH GP OUT OF OFFICE INDIVIDUAL COUNSELLING $73.87
13021 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 1ST HOUR $85.77
13022 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 2ND HOUR $42.92
13020 TELEHEALTH GENERAL PRACTITIONER ASSISTANT $30.32
13015 HIV/AIDS PRIMARY CARE MGMT - PER 1/2 HR OR $83.78
00103 HOME VISIT - CALL PLACED BETWEEN 0800 AND 2300HRS $110.97
13655 GENERAL PRACTICE - VASECTOMY BONUS $20.56
00117 ECG INTERPRETATION ONLY G.P. $9.95
03333 NO CHARGE REFERRAL $0.00