General practice MSP billing codes


Consultations

Code Description Amount
00110 IN OFFICE: AGE 2-49-CONSULTATION $76.20
00116 SPECIAL IN-HOSPITAL, CONSULTATION $161.91
12110 IN OFFICE:(AGE 0-1)-CONSULTATION $83.82
12210 OUT OF OFFICE (AGE 0-1)-CONSULTATION $100.59
13210 OUT OF OFFICE (AGE 2-49)-CONSULTATION $91.44
15210 OUT OF OFFICE (AGE 50-59)-CONSULTATION $100.59
15310 IN OFFICE (AGE 50-59)-CONSULTATION $83.82
16110 IN OFFICE:(AGE 60-69)-CONSULTATION $87.63
16210 OUT OF OFFICE (AGE 60-69)-CONSULTATION $105.16
17110 IN OFFICE: (AGE 70-79)-CONSULTATION $99.05
17210 OUT OF OFFICE (AGE 70-79)-CONSULTATION $118.86
18110 IN OFFICE: (AGE 80+)-CONSULTATION $114.31
18210 OUT OF OFFICE (AGE 80+)-CONSULTATION $137.18

Complete Examinations

Code Description Amount
00101 IN OFFICE (AGE 2-49)-COMPLETE EXAMINATION $69.33
12101 IN OFFICE (AGE 0-1)-COMPLETE EXAMINATION $76.26
12201 OUT OF OFFICE (AGE 0-1)-COMPLETE EXAMINATION $91.51
13201 OUT OF OFFICE (AGE 2-49)-COMPLETE EXAMINATION $83.20
15201 OUT OF OFFICE (AGE 50-59)-COMPLETE EXAMINATION $91.51
15301 IN OFFICE (AGE 50-59)-COMPLETE EXAMINATION $76.26
16101 IN OFFICE (AGE 60-69)-COMPLETE EXAMINATION $79.72
16201 OUT OF OFFICE (AGE 60-69)-COMPLETE EXAMINATION $95.67
17101 IN OFFICE (AGE 70-79)-COMPLETE EXAMINATION $90.12
17201 OUT OF OFFICE (AGE 70-79)-COMPLETE EXAMINATION $108.14
18101 IN OFFICE (AGE 80+)-COMPLETE EXAMINATION $104.01
18201 OUT OF OFFICE (AGE 80+)-COMPLETE EXAMINATION $124.80

Visits

Code Description Amount
00100 VISIT IN OFFICE (AGE 2 - 49) $31.23
00105 ON CALL, ON SITE HOSPITAL VISIT - NIGHT $71.06
00111 VISIT, EMERGENCY HOME $115.65
00112 VISIT, EMERGENCY $114.29
00113 ON CALL, ON SITE HOSPITAL VISIT - EVENING $51.13
00123 ON CALL, ON SITE HOSPITAL VISIT - SAT, SUN OR HOLS $51.13
12100 VISIT IN OFFICE (AGE 0-1) $34.36
12200 VISIT - OUT OF OFFICE (AGE 0 - 1) $41.22
13070 IN OFFICE ASSESSMENT IN ASSOC WITH A WSBC SERVICE $16.24
13075 IN OFFICE ASSESSMENT IN ASSOC WITH AN ICBC SERVICE $16.24
13200 VISIT - OUT OF OFFICE (AGE 2-49) $37.48
15200 VISIT OUT OF OFFICE (AGE 50-59) $41.22
15300 VISIT IN OFFICE (AGE 50-59) $34.36
16100 VISIT IN OFFICE (AGE 60-69) $35.91
16200 VISIT - OUT OF OFFICE (AGE 60-69) $43.10
17100 VISIT IN OFFICE (AGE 70-79) $40.60
17200 VISIT - OUT OF OFFICE (AGE 70-79) $48.71
18100 VISIT IN OFFICE (AGE 80+) $46.85
18200 VISIT - OUT OF OFFICE (AGE 80+) $56.21

Group Medical Visits

Code Description Amount
13763 GENERAL PRACTICE GROUP MEDICAL VISIT - 3 PATIENTS $25.55
13764 GENERAL PRACTICE GROUP MEDICAL VISIT - 4 PATIENTS $20.64
13765 GENERAL PRACTICE GROUP MEDICAL VISIT - 5 PATIENTS $17.73
13766 GENERAL PRACTICE GROUP MEDICAL VISIT - 6 PATIENTS $15.78
13767 GENERAL PRACTICE GROUP MEDICAL VISIT - 7 PATIENTS $14.39
13768 GENERAL PRACTICE GROUP MEDICAL VISIT - 8 PATIENTS $13.36
13769 GENERAL PRACTICE GROUP MEDICAL VISIT - 9 PATIENTS $12.52
13770 GENERAL PRACTICE GROUP MEDICAL VISIT - 10 PATIENTS $11.87
13771 GENERAL PRACTICE GROUP MEDICAL VISIT - 11 PATIENTS $10.40
13772 GENERAL PRACTICE GROUP MEDICAL VISIT - 12 PATIENTS $9.78
13773 GENERAL PRACTICE GROUP MEDICAL VISIT - 13 PATIENTS $9.05
13774 GENERAL PRACTICE GROUP MEDICAL VISIT - 14 PATIENTS $8.89
13775 GENERAL PRACTICE GROUP MEDICAL VISIT - 15 PATIENTS $8.53
13776 GENERAL PRACTICE GROUP MEDICAL VISIT - 16 PATIENTS $8.28
13777 GENERAL PRACTICE GROUP MEDICAL VISIT - 17 PATIENTS $7.94
13778 GENERAL PRACTICE GROUP MEDICAL VISIT - 18 PATIENTS $7.76
13779 GENERAL PRACTICE GROUP MEDICAL VISIT - 19 PATIENTS $7.48
13780 GENERAL PRACTICE GROUP MEDICAL VISIT - 20 PATIENTS $7.30
13781 GENERAL PRACTICE GROUP MEDICAL VISIT- >20 PATIENTS $7.03

Counselling Individual

Code Description Amount
00120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 2-49) $54.35
12120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) $59.78
12220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 0 - 1) $71.72
13220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 2-49) $65.20
15220 INDIVIDUAL COUNSELLING OUT OF OFFICE (AGE 50-59) $71.72
15320 INDIVIDUAL COUNSELLING IN OFFICE (AGE 50-59) $59.78
16120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 60 - 69) $62.49
16220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 60-69) $74.99
17120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) $70.64
17220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 70-79) $84.77
18120 INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) $81.51
18220 INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 80 +) $97.82

Counselling Group

Code Description Amount
00121 GROUP COUNSELLING-FIRST FULL HOUR $87.34
00122 GROUP COUNSELLING-2ND HOUR/PER HALF OR MAJOR PART $43.69

Facility Visits

Code Description Amount
00108 HOSPITAL VISIT $31.69
00109 ACUTE CARE HOSPITAL ADMISSION VISIT $81.00
00114 VISIT NURSING HOME ONE OR MULTIPLE PATIENTS $35.86
00115 NURSING HOME VISIT - 1 PATIENT WHEN SPECIALLY CALL $114.29
00127 TERMINAL CARE FACILITY VISIT $53.20
00128 SUPPORTIVE CARE HOSPITAL VISIT $27.32
13334 LTC FACILITY VISIT-FIRST VISIT OF DAY BONUS,EXTRA $33.81

Community Based Gp Hospital Visits

Code Description Amount
13008 COMMUNITY BASED GP: HOSPITAL VISIT $53.20
13028 COMMUNITY BASED GP: SUPPORTIVE CARE HOSP VISIT $35.34
13228 COMMUNITY BASED GP: HOSPITAL VISIT $29.63
13338 COMMUNITY BASED GP,1ST FAC VISIT OF DAY BONUS,EXTR $37.82
13339 COM BASED GP,1ST HOSP VISIT OF DAY BONUS, EXTRA $29.63

Phone Calls & Email

Code Description Amount
13005 Phone Call (Advice about patient in Community Care) $15.60
13000 TELEPHONE ADVICE IN FIRST NATIONS COMMUNITIES $15.60
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 $89.69
00119 NEWBORN CARE, ROUTINE, IN HOSPITAL $91.67
14004 FULL SERVICE GP-OBSTET DELIVERY BONUS-W DELIVERY $288.77
14005 FULL SERVICE GP-BONUS WITH TRANSFER HIGHER CARE $120.26
14008 FULL SERVICE GP-BONUS WITH POST NATAL CARE $59.41
14009 FULL SERVICE GP-OBSTET DELIVERY BONUS-W C SECTION $240.54
14090 PRENATAL VISIT- COMPLETE EXAMINATION $83.38
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $31.23
14094 POST-NATAL OFFICE VISIT $31.23
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $577.54
14105 MANAGEMENT OF LABOUR AND TRANSFER TO HIGHER LEVEL $240.52
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $118.82
14109 DELIVERY - ATTENDANCE - EMERG C/S $481.07
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $83.89
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $42.62
14545 MEDICAL ABORTION $162.92
14560 ROUTINE PELVIC EXAM INCLUDING PAP $31.23
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.50
14010 Maternity Network Incentive $2,100.00

Surgical Assistance

Code Description Amount
00193 NON-CVT CERT. SURGICAL ASSIST @ OPEN HEART SURGERY $29.36
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $133.22
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $187.83
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $256.18
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $28.31
13052 ANAES. EVALUATION - NON-CERTIFIED ANAESTHETIST $46.40
13194 GP FIRST SURGICAL ASSIST OF THE DAY $87.07

Procedures

Code Description Amount
00190 ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. $31.23
10710 IN-OFFICE ANOSCOPY $7.84
13600 BIOPSY - MUCOSA/SKIN (OPERATION ONLY) $51.28
13601 BIOPSY - FACIAL AREA (OPERATION ONLY) $51.28
13605 ABSCESS - SUPERFICIAL $43.93
13610 MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA $35.18
13611 MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. $65.53
13612 EXTENSIVE LACERATION GREATER THAN 5CM $13.15
13620 EXCISION TUMOR OF SKIN/SCAR UP TO 5CM $65.53
13621 EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM $32.76
13622 LOCALIZED CARCINOMA OF SKIN PROVEN HISTOPATH. $72.40
13630 PARONYCHIA $35.09
13631 NAIL REMOVAL - SIMPLE $35.09
13632 NAIL REMOVAL WITH DESTRUCTION OF NAIL BED $71.00
13633 WEDGE EXCISION OF ONE NAIL $62.65
13650 ENUCLEATION OR EXCISION OF EXT THROMBOTIC HAEMORRH $51.47
13660 METATARSAL BONE - CLOSED REDUCTION $52.13

Laboratory Services

Code Description Amount
00012 INJECTION, VENEPUNCTURE $5.88
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.61
15100 GLUCOSE - SEMIQUANTITATIVE $3.65
15110 OCCULT BLOOD - FECES $5.27
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.50
15130 URINALYSIS - SCREENING $2.15
15131 URINALYSIS - MICRO EXAM OF CENTRIFUGED DEPOSIT $4.07
15132 CANDIDA CULTURE (IN PHYSICIANS OFFICE) $6.62
15133 EXAMINATION OF EOSINOPHILS/SECRETIONS/EXCRETIONS $7.09
15134 PINWORM OVA-EXAMINATION $5.81
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.33
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.10
15138 SEDIMENTATION RATE (IN PHYSICIANS OFFICE) $2.49
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.67
15140 STAINED SMEAR (IN PHYSICIANS OFFICE) $7.34
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.58
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.55
15143 WHITE CELL COUNT ONLY $6.43
30015 EOSINOPHILS - SECRETION SMEAR $7.24
93120 E.C.G. TRACING, WITHOUT INTERPRETATION (TECHNICAL) $16.70

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 $54.35
14045 GP MENTAL HEALTH MANAGEMENT FEE AGE 50-59 $59.78
14046 GP MENTAL HEALTH MANAGEMENT FEE AGE 60-69 $62.49
14047 GP MENTAL HEALTH MANAGEMENT FEE AGE 70-79 $70.64
14048 GP MENTAL HEALTH MANAGEMENT FEE AGE 80+ $81.51

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
13036 TELEHEALTH GP IN-OFFICE CONSULTATION $81.82
13037 TELEHEALTH GP IN-OFFICE VISIT $34.18
13038 TELEHEALTH GP IN-OFFICE INDIVIDUAL COUNSELLING $58.46
13041 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING/1ST HR $86.29
13042 TELEHEALTH GP IN-OFFICE GROUP COUNSELLING - 2ND HR $43.18
13016 TELEHEALTH GP OUT OF OFFICE CONSULTATION $108.21
13017 TELEHEALTH GP OUT OF OFFICE VISIT $40.79
13018 TELEHEALTH GP OUT OF OFFICE INDIVIDUAL COUNSELLING $74.76
13021 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 1ST HOUR $86.81
13022 TELEHEALTH GP OUT OF OFFICE GROUP COUNSEL 2ND HOUR $43.43
13020 TELEHEALTH GENERAL PRACTITIONER ASSISTANT $31.23
13015 HIV/AIDS PRIMARY CARE MGMT - PER 1/2 HR OR $85.31
00103 HOME VISIT - CALL PLACED BETWEEN 0800 AND 2300HRS $114.29
13655 GENERAL PRACTICE - VASECTOMY BONUS $21.17
00117 ECG INTERPRETATION ONLY G.P. $10.25
03333 NO CHARGE REFERRAL $0.00