General practice MSP billing codes


Consultations

Code Description Amount
00110 IN OFFICE: AGE 2-49-CONSULTATION $77.15
00116 SPECIAL IN-HOSPITAL, CONSULTATION $163.94
12110 IN OFFICE:(AGE 0-1)-CONSULTATION $84.87
12210 OUT OF OFFICE (AGE 0-1)-CONSULTATION $100.59
13210 OUT OF OFFICE (AGE 2-49)-CONSULTATION $92.59
15210 OUT OF OFFICE (AGE 50-59)-CONSULTATION $101.85
15310 IN OFFICE (AGE 50-59)-CONSULTATION $84.87
16110 IN OFFICE:(AGE 60-69)-CONSULTATION $88.73
16210 OUT OF OFFICE (AGE 60-69)-CONSULTATION $106.48
17110 IN OFFICE: (AGE 70-79)-CONSULTATION $100.29
17210 OUT OF OFFICE (AGE 70-79)-CONSULTATION $120.35
18110 IN OFFICE: (AGE 80+)-CONSULTATION $115.75
18210 OUT OF OFFICE (AGE 80+)-CONSULTATION $138.90

Complete Examinations

Code Description Amount
00101 IN OFFICE (AGE 2-49)-COMPLETE EXAMINATION $69.85
12101 IN OFFICE (AGE 0-1)-COMPLETE EXAMINATION $76.83
12201 OUT OF OFFICE (AGE 0-1)-COMPLETE EXAMINATION $92.20
13201 OUT OF OFFICE (AGE 2-49)-COMPLETE EXAMINATION $83.20
15201 OUT OF OFFICE (AGE 50-59)-COMPLETE EXAMINATION $92.20
15301 IN OFFICE (AGE 50-59)-COMPLETE EXAMINATION $76.83
16101 IN OFFICE (AGE 60-69)-COMPLETE EXAMINATION $80.32
16201 OUT OF OFFICE (AGE 60-69)-COMPLETE EXAMINATION $96.39
17101 IN OFFICE (AGE 70-79)-COMPLETE EXAMINATION $90.80
17201 OUT OF OFFICE (AGE 70-79)-COMPLETE EXAMINATION $108.95
18101 IN OFFICE (AGE 80+)-COMPLETE EXAMINATION $104.79
18201 OUT OF OFFICE (AGE 80+)-COMPLETE EXAMINATION $125.74

Visits

Code Description Amount
00100 VISIT IN OFFICE (AGE 2 - 49) $31.62
00105 ON CALL, ON SITE HOSPITAL VISIT - NIGHT $71.95
00111 VISIT, EMERGENCY HOME $117.10
00112 VISIT, EMERGENCY $115.73
00113 ON CALL, ON SITE HOSPITAL VISIT - EVENING $51.77
00123 ON CALL, ON SITE HOSPITAL VISIT - SAT, SUN OR HOLS $51.77
12100 VISIT IN OFFICE (AGE 0-1) $34.79
12200 VISIT - OUT OF OFFICE (AGE 0 - 1) $41.22
13070 IN OFFICE ASSESSMENT IN ASSOC WITH A WSBC SERVICE $16.44
13075 IN OFFICE ASSESSMENT IN ASSOC WITH AN ICBC SERVICE $16.44
13200 VISIT - OUT OF OFFICE (AGE 2-49) $37.95
15200 VISIT OUT OF OFFICE (AGE 50-59) $41.74
15300 VISIT IN OFFICE (AGE 50-59) $34.79
16100 VISIT IN OFFICE (AGE 60-69) $36.36
16200 VISIT - OUT OF OFFICE (AGE 60-69) $43.73
17100 VISIT IN OFFICE (AGE 70-79) $41.10
17200 VISIT - OUT OF OFFICE (AGE 70-79) $49.33
18100 VISIT IN OFFICE (AGE 80+) $47.44
18200 VISIT - OUT OF OFFICE (AGE 80+) $56.91

Group Medical Visits

Code Description Amount
13763 GENERAL PRACTICE GROUP MEDICAL VISIT - 3 PATIENTS $25.87
13764 GENERAL PRACTICE GROUP MEDICAL VISIT - 4 PATIENTS $20.89
13765 GENERAL PRACTICE GROUP MEDICAL VISIT - 5 PATIENTS $17.95
13766 GENERAL PRACTICE GROUP MEDICAL VISIT - 6 PATIENTS $15.98
13767 GENERAL PRACTICE GROUP MEDICAL VISIT - 7 PATIENTS $14.57
13768 GENERAL PRACTICE GROUP MEDICAL VISIT - 8 PATIENTS $13.53
13769 GENERAL PRACTICE GROUP MEDICAL VISIT - 9 PATIENTS $12.67
13770 GENERAL PRACTICE GROUP MEDICAL VISIT - 10 PATIENTS $12.02
13771 GENERAL PRACTICE GROUP MEDICAL VISIT - 11 PATIENTS $10.53
13772 GENERAL PRACTICE GROUP MEDICAL VISIT - 12 PATIENTS $9.90
13773 GENERAL PRACTICE GROUP MEDICAL VISIT - 13 PATIENTS $9.17
13774 GENERAL PRACTICE GROUP MEDICAL VISIT - 14 PATIENTS $9.00
13775 GENERAL PRACTICE GROUP MEDICAL VISIT - 15 PATIENTS $8.63
13776 GENERAL PRACTICE GROUP MEDICAL VISIT - 16 PATIENTS $8.38
13777 GENERAL PRACTICE GROUP MEDICAL VISIT - 17 PATIENTS $8.04
13778 GENERAL PRACTICE GROUP MEDICAL VISIT - 18 PATIENTS $7.86
13779 GENERAL PRACTICE GROUP MEDICAL VISIT - 19 PATIENTS $7.58
13780 GENERAL PRACTICE GROUP MEDICAL VISIT - 20 PATIENTS $7.39
13781 GENERAL PRACTICE GROUP MEDICAL VISIT- >20 PATIENTS $7.12

Counselling Individual

Code Description Amount
00120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 2-49) $56.41
12120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) $62.05
12220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 0 - 1) $74.44
13220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 2-49) $67.67
15220 INDIVIDUAL COUNSELLING OUT OF OFFICE (AGE 50-59) $74.44
15320 INDIVIDUAL COUNSELLING IN OFFICE (AGE 50-59) $62.05
16120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 60 - 69) $64.86
16220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 60-69) $77.83
17120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) $73.32
17220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 70-79) $87.99
18120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) $84.60
18220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 80 +) $101.52

Counselling Group

Code Description Amount
00121 GROUP COUNSELLING-FIRST FULL HOUR $160.00
00122 GROUP COUNSELLING-2ND HOUR/PER HALF OR MAJOR PART $80.00

Facility Visits

Code Description Amount
00108 HOSPITAL VISIT $31.93
00109 ACUTE CARE HOSPITAL ADMISSION VISIT $81.61
00114 VISIT NURSING HOME ONE OR MULTIPLE PATIENTS $36.31
00115 NURSING HOME VISIT - 1 PATIENT WHEN SPECIALLY CALL $115.73
00127 TERMINAL CARE FACILITY VISIT $53.87
00128 SUPPORTIVE CARE HOSPITAL VISIT $27.52
13334 LTC FACILITY VISIT-FIRST VISIT OF DAY BONUS,EXTRA $34.23

Community Based Gp Hospital Visits

Code Description Amount
13008 COMMUNITY BASED GP: HOSPITAL VISIT $53.87
13028 COMMUNITY BASED GP: SUPPORTIVE CARE HOSP VISIT $35.79
13228 COMMUNITY BASED GP: HOSPITAL VISIT $30.00
13338 COMMUNITY BASED GP,1ST FAC VISIT OF DAY BONUS,EXTR $49.72
13339 COM BASED GP,1ST HOSP VISIT OF DAY BONUS, EXTRA $30.00

Phone Calls & Email

Code Description Amount
13005 Phone Call (Advice about patient in Community Care) $18.22
13000 TELEPHONE ADVICE IN FIRST NATIONS COMMUNITIES $18.22
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 $90.81
00119 NEWBORN CARE, ROUTINE, IN HOSPITAL $92.82
14004 FULL SERVICE GP-OBSTET DELIVERY BONUS-W DELIVERY $375.40
14005 FULL SERVICE GP-BONUS WITH TRANSFER HIGHER CARE $156.34
14008 FULL SERVICE GP-BONUS WITH POST NATAL CARE $77.23
14009 FULL SERVICE GP-OBSTET DELIVERY BONUS-W C SECTION $312.70
14090 PRENATAL VISIT- COMPLETE EXAMINATION $84.43
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $31.62
14094 POST-NATAL OFFICE VISIT $31.62
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $584.78
14105 MANAGEMENT OF LABOUR AND TRANSFER TO HIGHER LEVEL $243.53
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $120.31
14109 DELIVERY - ATTENDANCE - EMERG C/S $487.10
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $84.94
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $43.15
14545 MEDICAL ABORTION $164.96
14560 ROUTINE PELVIC EXAM INCLUDING PAP $31.62
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.65
14010 Maternity Network Incentive $2,100.00

Surgical Assistance

Code Description Amount
00193 NON-CVT CERT. SURGICAL ASSIST @ OPEN HEART SURGERY $29.84
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $134.22
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $189.24
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $260.35
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $28.52
13052 ANAES. EVALUATION - NON-CERTIFIED ANAESTHETIST $55.76
13194 GP FIRST SURGICAL ASSIST OF THE DAY $88.16

Procedures

Code Description Amount
00190 ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. $31.62
10710 IN-OFFICE ANOSCOPY $7.94
13600 BIOPSY - MUCOSA/SKIN (OPERATION ONLY) $51.92
13601 BIOPSY - FACIAL AREA (OPERATION ONLY) $51.92
13605 ABSCESS - SUPERFICIAL $44.48
13610 MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA $35.62
13611 MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. $66.35
13612 EXTENSIVE LACERATION GREATER THAN 5CM $13.32
13620 EXCISION TUMOR OF SKIN/SCAR UP TO 5CM $66.35
13621 EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM $33.18
13622 LOCALIZED CARCINOMA OF SKIN PROVEN HISTOPATH. $73.30
13630 PARONYCHIA $35.53
13631 NAIL REMOVAL - SIMPLE $35.53
13632 NAIL REMOVAL WITH DESTRUCTION OF NAIL BED $71.89
13633 WEDGE EXCISION OF ONE NAIL $63.44
13650 ENUCLEATION OR EXCISION OF EXT THROMBOTIC HAEMORRH $52.12
13660 METATARSAL BONE - CLOSED REDUCTION $52.78

Laboratory Services

Code Description Amount
00012 INJECTION, VENEPUNCTURE $5.95
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.62
15100 GLUCOSE - SEMIQUANTITATIVE $3.70
15110 OCCULT BLOOD - FECES $5.34
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.65
15130 URINALYSIS - SCREENING $2.18
15131 URINALYSIS - MICRO EXAM OF CENTRIFUGED DEPOSIT $4.12
15132 CANDIDA CULTURE (IN PHYSICIANS OFFICE) $6.67
15133 EXAMINATION OF EOSINOPHILS/SECRETIONS/EXCRETIONS $7.14
15134 PINWORM OVA-EXAMINATION $5.85
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.33
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.12
15138 SEDIMENTATION RATE (IN PHYSICIANS OFFICE) $2.51
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.78
15140 STAINED SMEAR (IN PHYSICIANS OFFICE) $7.40
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.65
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.62
15143 WHITE CELL COUNT ONLY $6.48
30015 EOSINOPHILS - SECRETION SMEAR $7.29
93120 E.C.G. TRACING, WITHOUT INTERPRETATION (TECHNICAL) $16.90

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 $56.41
14045 GP MENTAL HEALTH MANAGEMENT FEE AGE 50-59 $62.05
14046 GP MENTAL HEALTH MANAGEMENT FEE AGE 60-69 $64.86
14047 GP MENTAL HEALTH MANAGEMENT FEE AGE 70-79 $73.32
14048 GP MENTAL HEALTH MANAGEMENT FEE AGE 80+ $84.60

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 $20.00
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
00103 HOME VISIT - CALL PLACED BETWEEN 0800 AND 2300HRS $115.73
00117 ECG INTERPRETATION ONLY G.P. $10.38
03333 NO CHARGE REFERRAL $0.00
13015 HIV/AIDS PRIMARY CARE MGMT - PER 1/2 HR OR $85.95
13016 TELEHEALTH GP OUT OF OFFICE CONSULTATION $109.02
13017 TELEHEALTH GP OUT OF OFFICE VISIT $41.10
13018 TELEHEALTH GP OUT OF OFFICE INDIVIDUAL COUNSELLING $75.32
13020 TELEHEALTH GENERAL PRACTITIONER ASSISTANT $31.46
13021 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 1ST HOUR $87.46
13022 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 2ND HOUR $43.76
13036 TELEHEALTH GP IN-OFFICE CONSULTATION $82.43
13037 TELEHEALTH GP IN-OFFICE VISIT $34.44
13038 TELEHEALTH GP IN-OFFICE INDIVIDUAL COUNSELLING $58.90
13041 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING/1ST HR $86.94
13042 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING - 2ND HR $43.50
13655 GENERAL PRACTICE - VASECTOMY BONUS $21.44