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 GP Attachment Complex Care Management Fee is advance payment for the complexity of caring for patients with eligible conditions and is payable upon the completion and documentation of the Complex Care Plan/Advance Care Plan (ACP) for the management of the complex care patient during that calendar year.
This initial expansion of the Complex Care fee encompasses those patients with a qualifying diagnosis of Frailty as defined by a Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale score of six or more, indicating the patient is Moderately or Severely Frail.
A complex care plan requires documentation of the following elements in the patient’s chart:
o There has been a detailed review of the case/chart and of current therapies.
o There has been a face-to-face visit with the patient, or the patient’s medical representative if appropriate, on the same calendar day that the GP Attachment Complex Care Management Fee is billed.
o Specifies a clinical plan for the care of that patient’s chronic condition(s).
o Incorporates the patient’s values and personal health goals in the care plan with respect to the chronic condition(s).
o Outlines expected outcomes as a result of this plan, including any advance care planning for end-of-life issues when clinically appropriate.
o Outlines linkages with other health care professionals that would be involved in the care, their expected roles.
o Identifies an appropriate time frame for re-evaluation of the plan.
o Confirms that the care plan has been communicated verbally or in writing to the patient and/or the patient’s medical representative, and to other involved health professionals as indicated.
The development of the care plan is done jointly with the patient and/or the patient representative as appropriate. 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.
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.
iii) Applicable only to services submitted with diagnostic code V15 for the eligible patient population of frailty.
iv) Visit or CPx fee to indicate face-to-face interaction with patient same day must accompany billing.
v) Payable in addition to office visit or home visit same day.
vi) G14077 GP Attachment Patient Conference Fee payable on the same day for the same patient, for patients located in the community only as facility patients not eligible.
vii) Minimum required time 30 minutes in addition to visit time same day.
viii) 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.
ix) G14033 GP Annual Complex Care Management Fee is not payable in the same calendar year for same patient as G14075 GP Attachment Complex Care Fee.
x) 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.
xi) 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.
xii) Not payable to physicians working under salary, service contract or sessional arrangements whose duties would otherwise include provision of this care.