General practice 14053 - Incentive for gp annual chronic care bonus copd

General Info

Billing Amount: $125.00

Notes:

This is an incentive payment and is available to B.C.’s eligible family physicians. The purpose of the incentive payments is to improve patient care. GPSC retains the right to modify or change fees.
Physicians are eligible toparticipate in the incentive program if they are:
1. A general practitioner who has a valid BC MSP practitioner number (registered specialty 00). Practitioners who have billed any specialty consultation fee in the previous 12 months are not eligible.
2. Currently in general practice in BC as a full service family physician; and
3. Responsible for providing the patient’s longitudinal general practice care.
Additional detailed eligibility requirements are identified in each section.

Successful billing of the Annual Chronic Care Bonus for COPD (G14053) allows access to 5 Telephone/E-mail follow-up fees (G14079) per calendar year over the following 18 months.

i) General Practitioners who have a valid MSP practitioner number (registered specialty 00) are eligible to bill. Physicians who have billed a specialty consultation fee within the preceding 12 months are not eligible.
ii) Payable to the family physician who has provided the majority of the patient’s longitudinal general practice care and a clinically appropriate level of guideline-informed care for diabetes in the preceding year.
iii) Applicable only for patients with confirmed diagnosis of diabetes mellitus.
iv) This item may only be billed after one year of care has been provided and the patient has been seen at least twice in the preceding 12 months.
v) The patient must be given a copy of their personalized COPD care plan in order to facilitate patient self-management.
vi) Claim must include the ICD-9 code for chronic bronchitis (491), emphysema 492), bronchiectasis (494) or chronic airways obstruction-not elsewhere classified (496).
vii) This item may only be claimed once per patient in a consecutive 12 month period.
viii) Payable when other CDM items G14050, G14051 or G14052 have been paid on the same patient.
ix) If a visit is provided on the same date the bonus is billed; both services will be paid at the full fee.

Successful billing of the Annual Chronic Care Bonus for COPD (G14053) allows access to 5 Telephone/E-mail follow-up fees (G14079) per calendar year over the following 18 months.

In order to encourage non-face-to-face communication with patients covered by some of the GPSC incentives, the initial four separate telephone/e-mail follow up fees have been simplified into a single code that will still apply to the planning incentives (Complex Care G14033, Mental Health G14043, Palliative Care G14063 & COPD G14053 which requires a COPD Action Plan). Patients covered by one or more of these incentives are eligible for five telephone/e-mail services over the 18 months following the billing of the qualifying incentive(s).