General practice 14066 - Personal health risk assessment

General Info

Billing Amount: $50.00

Description

This fee is payable to the general practitioner who undertakes a Personal Health Risk Assessment with their patients who belong to one of the designated target populations (obese, smoker, physically inactive, unhealthy eating) either as part of proactive care or in response to a request for preventative care from one of these patients. The GP is expected to develop a plan that recommends age and sex specific targeted clinical preventative actions of proven benefit, consistent with the Lifetime Prevention Schedule and GPAC Obesity and Cardiovascular Disease – Primary Prevention Guidelines. The Personal Health Risk Assessment requires a face to face visit with the patient or patient’s medical representative and must be billed in addition to the age appropriate visit fee.

Notes:

Patient Eligibility:
• Eligible patients are community based, living in their home, with family, in supportive housing or assisted living. Facility based patients are not eligible.

Payable only for patients with one or more of the following risk factors: Smoking, unhealthy eating, physically inactive, medical obesity.

Only applicable to services submitted using one of the following diagnostic codes: Smoking (786), Unhealthy Eating (783), physically inactive (785), Medical Obesity (783).

iii) Requires chart entry documenting discussion and preventative plan of action.
iv) Face to face visit required with patient or patient’s medical representative on the same calendar day that the personal health risk assessment is billed.
v) Payable in addition to the office visit billed on the same day.
vi) Not payable on the same day as fee items G14015, G14017, G14033, G14043, G14063.
vii) Payable to a maximum of 100 patients per calendar year, per physician.
viii) Payable once per calendar year per patient.
ix) 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;
x) Not payable to physicians working under salary, service contract or sessional arrangements whose duties would otherwise include provision of this care.