The fee codes for the A GP for Me, also known as the Attachment initiative, will be available to all family doctors who submit the MSP fee G14070 ‘GP Attachment Participation Code’, a zero-sum amount, at the beginning of each calendar year. This will in turn open the door to the new Attachment initiative suite of fees. Billing the zero sum fee code signifies that:
• You are providing full-service family practice services to your patients, and will continue to do so for the duration of that calendar year.
• You are confirming your doctor-patient relationship with your existing patients through a standardized conversation or ‘compact’. Refer to A GP for Me –Frequently asked questions Q6 for details.
• You have contacted your local division of family practice to share your contact information and to indicate your desire to participate in the community-level Attachment initiative as you are able. Refer to A GP for Me –Frequently asked questions Q20 and Q21 for more information.
Prior to submitting the GP Attachment Participation Code, each participating family physician must register their intent to participate in A GP for Me with their local division, even if he/she is not a member of that local division. This will assist the local division to understand how many doctors in their area are prepared to support Attachment initiative efforts. Division contacts are available online at www.divisionsbc.ca.
The standardized wording of the Family Physician-Patient ‘Compact’ was developed in consultation with the physicians of the three Attachment prototype communities and in consultation with members of the Patient Voices Network. The compact states:
As your family doctor I, along with my practice team, agree to:
• Provide you with the best care that I can
• Coordinate any specialty care you may need
• Offer you timely access to care, to the best of my ability
• Maintain an ongoing record of your health
• Keep you updated on any changes to services offered at my clinic
• Communicate with you honestly and openly so we can best address your health care needs
As my patient I ask that you:
• Seek your health care from me and my team whenever possible and, in my absence, through my colleague(s), xxxxxx
• Name me as your family doctor if you have to visit an emergency facility or another provider
• Communicate with me honestly and openly so we can best address your health care needs
The Attachment incentives are available for BC residents only; reciprocal are excluded. Rural retention premiums do not apply.
The Unattached Complex/High Needs Patient Attachment fee is intended to compensate for the often time consuming and intensive process of integrating a new patient with higher needs into a family physician’s practice. This fee is paid in addition to the visit fee, and covers the initial meetings, organization of a medical record, and organization and enactment of appropriate Clinical Action Plan(s) as discussed with the patient.
Billing this incentive requires the accepting family physician to collate and review the relevant patient record to date and to meet with the patient to discuss this information and determine what supports will be needed to provide for the patient’s ongoing medical needs, taking into account his/her personal goals of care. By billing this incentive, the FP commits to providing care to the patient for at least one year. The patient populations eligible for this intake fee are:o Frail in Care (CSHA Clinical Frailty Scale score of six or more in residential care – new admissions only with exceptions for extenuating circumstances such as sudden departure from practice of existing MRP FP)
o Frail in the Community (CSHA Clinical Frailty Scale score of six or more)
o Significant Cancer o Moderate to High Needs Complex Chronic Conditions
o Severe Disability in the community o Mental Health and Substance Use
o New Mother and Infant(s) (intake can occur at any time during pregnancy up to 18 months of age. Each mother/child(ren) dyad counts as one unit for the purpose of billing this fee code)
Payable only to Family Physicians who have successfully submitted the GP Attachment Participation Code G14070 on the same or a prior date in the same calendar year.
ii) Payable only for unattached new patients who have been referred from Acute Care: ER and Admitted, Mental Health/Substance Use Workers/Clinics, Home and Community Care, BC Cancer Agency or Regional Centres, Public Health Colleagues, Local Division and do not already have a Family Physician. Patients who are already attached to a Family Physician in the same community are not eligible (i.e. Not for transfers between FPs unless moving to a new community).
iii) Visit fee to indicate face-to-face interaction with patient same day must accompany billing.
iv) Payable in addition to office visit, home visit or residential care visit same day.
v) G14077 GP Attachment Conference Fee payable on same day for same patient if all criteria met.
vi) G14033 Complex Care Management Fee and G14075 GP Attachment Complex Care Management Fee not payable on same day for same patient.
vii) Not payable for patients located in acute care.
viii) G14015 Facility Patient Conference Fee, G14016 Community Patient Conference Fee and G14017 Acute Care Discharge Planning Fee not payable in addition, as these fees not payable to FPs who have submitted the GP Attachment Participation Code. Instead, these physicians should use G14077 GP Attachment Conference Fee.
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.
xi) Maximum of 5 complex care fees (G14033 and/or G14075) and/or GP unattached complex/high needs patient attachment fees (G14074) per day per physician.