General practice 14063 - Palliative care planning fee-general practice

General Info

Billing Amount: $100.00

Description

This fee is payable upon the development and documentation of a Palliative Care Plan for patients who have been determined to have reached the palliative stage of a life-limiting disease or illness, with life expectancy of up to 6 months, and who consent to the focus of care being palliative rather than treatment aimed at cure. Medical Diagnoses include end-stage cardiac, respiratory, renal and liver disease, end stage dementia, degenerative neuromuscular disease, HIV/AIDS or malignancy. Eligible patients must be resident in the community; in a home or in assisted living or supportive housing. Facility-resident patients are not eligible for this initiative. This fee requires the GP to conduct a comprehensive review of the patient’s chart/history and assessment of the patient’s current diagnosis to determine if the patient has a life-limiting condition that has become palliative and/or remains palliative. It requires a face-to-face visit and assessment of the patient. If the patient is incapable of participating in the assessment to confirm and agree to their being palliative, then the patient’s alternate substitute decision maker or legal health representative must be consulted and asked to provide informed consent. The patient and/or their representative/family should leave the planning process knowing there is a plan for their care and what that plan is. Successful billing of the Palliative care planning fee (G14063) allows access to 5 Telephone/e-mail follow-up fees (G14079) per calendar year over the following 18 months.

Notes:

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).

Requires documentation of the patient’s medical diagnosis, determination that the patient has become palliative, and patient’s agreement to no longer seek treatment aimed at cure.

Patient must be eligible for BC Palliative Care Benefits Program (not necessary to have applied for palliative care benefits program).

iii) Payable once per patient once patient deemed to be palliative. Under circumstances when the patient moves communities after the initial palliative care planning fee has been billed, it may be billed by the new GP who is assuming the ongoing palliative care for the patient.
iv) Payable in addition to a visit fee billed on the same day.
v) Minimum required time 30 minutes in addition to visit time same day.
vi) G14016, community patient conferencing fee payable on same day for same patient if all criteria met.
vii) Not payable on same day as G14015, facility patient conferencing fee.
viii) Not payable on same day as G14017, acute care discharge planning.
ix) G14079 GP Telephone/e-mail management fee is not payable on the same day.
x) G14050, G14051, G14052, G14053, G14033, G14066 not payable once Palliative Care Planning fee is billed as patient has moved from active management of chronic disease to palliative.
xi) G14043, G14044, G14045, G14046, G14047, G14048, the GPSC Mental Health Initiative Fees are still payable once G14063 has been billed provided all requirements are met, but are not payable on same day.
xii) Not payable to physicians who are employed by or who are under contract to a facility and whose duties would otherwise include provision of this care.
xiii) Not payable to physicians working under salary, service contract or sessional arrangements whose duties would otherwise include provision of this care.