MSP Billing Codes

Specialty: Family Medicine

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Code Description Fee

Chronic Disease Management Incentives

14253 Gp annual chronic care incentive(encounter)-copd $125.78
14250 Gp annual chronic care incentive(encounter)-diabet $125.78
14251 Gp annual chronic care incentive(encounter)-heart $125.78
14252 Gp annual chronic care incentive(encounter)-hypert $50.31

Community Based GP Hospital Visits

13339 Com based gp,1st hosp visit of day bonus, extra $49.84
13008 Community based gp: hospital visit $54.20
13011 Community based gp: hospital visit $64.64
13012 Community based gp: hospital visit $43.23
13228 Community based gp: hospital visit $30.09
13028 Community based gp: supportive care hosp visit $36.01

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Complete Examinations

12101 In office (age 0-1)-complete examination $76.83
00101 In office (age 2-49)-complete examination $69.85
15301 In office (age 50-59)-complete examination $76.83
16101 In office (age 60-69)-complete examination $80.32
17101 In office (age 70-79)-complete examination $90.80
18101 In office (age 80+)-complete examination $104.79
12201 Out of office (age 0-1)-complete examination $92.20
13201 Out of office (age 2-49)-complete examination $83.82
15201 Out of office (age 50-59)-complete examination $92.20
16201 Out of office (age 60-69)-complete examination $96.39
17201 Out of office (age 70-79)-complete examination $108.95
18201 Out of office (age 80+)-complete examination $125.74

Consultations / Visits

13109 Community based gp:acute care hospital admission $103.16
14016 Community patient conference fee-general practice $40.00
00117 Ecg interpretation only g.p. $10.41
14015 Facility patient conference-general practice $40.00
14017 General practice acute care discharge conference $40.00
14019 Gp advice fee to np-telephone or in person $43.23
14078 Gp email/text/telephone medical advice relay fee $7.04
14079 Gp telephone/email management fee $15.00
14018 Gp urgent telephone conference with a specialist $43.23
14023 Gp with spec training tele patient mgmt-follow up $20.12
14021 Gp with specialty training tele advice - urgent $60.37
14022 Gp with specialty training tele patient mgmt 1 wk $43.23
13015 Hiv/aids primary care mgmt - per 1/2 hr or $85.95
00103 Home visit - call placed between 0800 and 2300hrs $116.09
15310 In office (age 50-59)-consultation $85.40
13070 In office assessment in assoc with a wsbc service $16.49
13075 In office assessment in assoc with an icbc service $16.49
17110 In office: (age 70-79)-consultation $100.91
18110 In office: (age 80+)-consultation $116.11
00110 In office: age 2-49-consultation $77.63
12110 In office:(age 0-1)-consultation $85.40
16110 In office:(age 60-69)-consultation $89.28
00113 On call, on site hospital visit - evening $51.93
00105 On call, on site hospital visit - night $72.17
00123 On call, on site hospital visit - sat, sun or hols $51.93
12210 Out of office (age 0-1)-consultation $102.48
13210 Out of office (age 2-49)-consultation $93.16
15210 Out of office (age 50-59)-consultation $102.48
16210 Out of office (age 60-69)-consultation $107.14
17210 Out of office (age 70-79)-consultation $121.10
18210 Out of office (age 80+)-consultation $139.76
13005 Phone call (advice about patient in community care) $18.28
00116 Special in-hospital, consultation $164.96
13000 Telephone advice in first nations communities $18.28
12200 Visit - out of office (age 0 - 1) $41.87
13200 Visit - out of office (age 2-49) $38.07
16200 Visit - out of office (age 60-69) $43.87
17200 Visit - out of office (age 70-79) $49.48
18200 Visit - out of office (age 80+) $57.09
12100 Visit in office (age 0-1) $34.90
00100 Visit in office (age 2 - 49) $31.72
15300 Visit in office (age 50-59) $34.90
16100 Visit in office (age 60-69) $36.47
17100 Visit in office (age 70-79) $41.22
18100 Visit in office (age 80+) $47.59
15200 Visit out of office (age 50-59) $41.87
00112 Visit, emergency $116.09
00111 Visit, emergency home $117.46

Counselling - Group

00122 Group counselling-2nd hour/per half or major part $80.50
00121 Group counselling-first full hour $160.99
13020 Telehealth general practitioner assistant $43.23
13036 Telehealth gp in-office consultation $82.43
13042 Telehealth gp in-office group counselling - 2nd hr $43.50
13041 Telehealth gp in-office group counselling/1st hr $86.94
13038 Telehealth gp in-office individual counselling $58.90
13037 Telehealth gp in-office visit $34.44
13016 Telehealth gp out of office consultation $109.02
13021 Telehealth gp out of office group counsel 1st hour $87.46
13022 Telehealth gp out of office group counsel 2nd hour $43.76
13018 Telehealth gp out of office individual counselling $75.32
13017 Telehealth gp out of office visit $41.10

Counselling - Individual

12220 Individual counselling - out of office (age 0 - 1) $74.90
13220 Individual counselling - out of office (age 2-49) $68.09
16220 Individual counselling - out of office (age 60-69) $78.31
17220 Individual counselling - out of office (age 70-79) $88.54
18220 Individual counselling - out of office (age 80 +) $102.15
19100 Individual counselling - out of office (age 80 +) $185.00
19101 Individual counselling - out of office (age 80 +) $185.00
19102 Individual counselling - out of office (age 80 +) $83.00
19103 Individual counselling - out of office (age 80 +) $55.00
19104 Individual counselling - out of office (age 80 +) $43.00
19105 Individual counselling - out of office (age 80 +) $43.00
12120 Individual counselling in office (age 0 - 1) $62.43
00120 Individual counselling in office (age 2-49) $56.76
15320 Individual counselling in office (age 50-59) $62.43
16120 Individual counselling in office (age 60 - 69) $65.26
17120 Individual counselling in office (age 70-79) $73.77
18120 Individual counselling in office (age 80+) $85.12
15220 Individual counselling out of office (age 50-59) $74.90

Facility Visits

00109 Acute care hospital admission visit $81.61
00108 Hospital visit $31.93
13334 Ltc facility visit-first visit of day bonus,extra $49.84
00115 Nursing home visit - 1 patient when specially call $116.45
00128 Supportive care hospital visit $27.52
00127 Terminal care facility visit $54.20
00114 Visit nursing home one or multiple patients $36.54

GP For Me Attachment Fees

14075 Gp attachment complex care management fee $316.95
14077 Gp attachment patient conference fee $43.23
14076 Gp attachment telephone management fee $20.12
14074 Gp unattached complex/high needs patient attachmen $200.00

GPSC Annual Bonuses

14033 Annual complex care management fee $316.95
14041 Annual complex care management fee $15.00
14050 Gp annual chronic care bonus - diabetes mellitus $125.78
14051 Gp annual chronic care bonus - heart failure $125.78
14052 Gp annual chronic care bonus - hypertension $50.31
14053 Incentive for gp annual chronic care bonus copd $125.78

Group Medical Visits

13770 General practice group medical visit - 10 patients $12.06
13771 General practice group medical visit - 11 patients $10.56
13772 General practice group medical visit - 12 patients $9.93
13773 General practice group medical visit - 13 patients $9.20
13774 General practice group medical visit - 14 patients $9.03
13775 General practice group medical visit - 15 patients $8.66
13776 General practice group medical visit - 16 patients $8.41
13777 General practice group medical visit - 17 patients $8.06
13778 General practice group medical visit - 18 patients $7.88
13779 General practice group medical visit - 19 patients $7.60
13780 General practice group medical visit - 20 patients $7.41
13763 General practice group medical visit - 3 patients $25.95
13764 General practice group medical visit - 4 patients $20.95
13765 General practice group medical visit - 5 patients $18.01
13766 General practice group medical visit - 6 patients $16.03
13767 General practice group medical visit - 7 patients $14.62
13768 General practice group medical visit - 8 patients $13.57
13769 General practice group medical visit - 9 patients $12.71
13781 General practice group medical visit- >20 patients $7.14
14002 General practice group medical visit- >20 patients $50.00

Gynecology & Pregnancy

00118 Caesarean section-attendance $91.09
14109 Delivery - attendance - emerg c/s $490.12
14104 Delivery and post-natal care (1-14 days in-hosp) $588.41
14008 Full service gp-bonus with post natal care $77.23
14005 Full service gp-bonus with transfer higher care $156.34
14009 Full service gp-obstet delivery bonus-w c section $312.70
14004 Full service gp-obstet delivery bonus-w delivery $375.40
14540 Insertion intrauterine contraceptive device $43.28
14105 Management of labour and transfer to higher level $245.04
14010 Maternity network incentive $2,100.00
14545 Medical abortion $165.47
14199 Mngmnt of prlngd 2nd stg labour - per 30 mins $85.47
00119 Newborn care, routine, in hospital $93.11
14108 Post-natal care after elective c-section $121.06
14094 Post-natal office visit $31.81
15120 Pregnancy test, immunologic, urine $11.72
14091 Prenatal visit - subsequent examination $31.81
14090 Prenatal visit- complete examination $84.95
14560 Routine pelvic exam including pap $31.72

Laboratory Services

15132 Candida culture (in physicians office) $6.67
93120 E.c.g. tracing, without interpretation (technical) $16.97
30015 Eosinophils - secretion smear $7.29
15133 Examination of eosinophils/secretions/excretions $7.14
15136 Fungus, direct examination, koh preparation $8.39
15100 Glucose - semiquantitative $3.70
15137 Haemoglobin - cyanmethaemoglobin $3.12
15000 Haemoglobin -other methods (in physicians office) $1.62
00012 Injection, venepuncture $5.99
15110 Occult blood - feces $5.37
15134 Pinworm ova-examination $5.85
15138 Sedimentation rate (in physicians office) $2.51
15139 Sperm, seminal examination for presence or absence $14.78
15140 Stained smear (in physicians office) $7.40
15141 Trichomonas and / or candida, direct examination $5.69
15130 Urinalysis - screening $2.19
15131 Urinalysis - micro exam of centrifuged deposit $4.15
15142 Urinalysis-complete diagnostic, semi-quant & micro $5.65
15143 White cell count only $6.48

Mental Health Planning & Management

14044 Gp mental health management fee age 2-49 $56.76
14045 Gp mental health management fee age 50-59 $62.43
14046 Gp mental health management fee age 60-69 $65.26
14047 Gp mental health management fee age 70-79 $73.77
14048 Gp mental health management fee age 80+ $85.12
14043 Gp mental health planning fee $100.62

Minor Procedures

13623 Excision tumour skin/subcututaneous/small scar $90.04
14541 Removal of intrauterine device (iud) $31.72
13624 Removal scars (5 cm or more) per cm over 5 c $8.62

Other GPSC Fees

14086 Gp assigned inpatient care network $2,100.00
14088 Gp unassigned inpatient care fee $150.00
14063 Palliative care planning fee-general practice $100.62
14066 Personal health risk assessment $50.31
14067 Personal health risk assessment $18.22

Procedures

13621 - additional lesions removed at the same sitting (maximum per sitting, five) each (operation only) $33.39
13601 Biopsy - facial area (operation only) $52.24
13600 Biopsy of skin or mucosa (operation only) $52.24
00190 Electrosurg./cryotherapy for removal of warts etc. $31.72
13650 Enucleation or excision of ext thrombotic haemorrh $52.44
13620 Excision of tumour of skin or subcutaneous tissue or small scar under local anesthetic - up to 5 cm (operation only) $66.76
13612 Extensive laceration greater than 5cm $13.40
10710 In-office anoscopy $7.96
13622 Localized carcinoma of skin proven histopath. $73.75
13660 Metatarsal bone - closed reduction $53.11
13701 Metatarsal bone - closed reduction $50.00
13702 Metatarsal bone - closed reduction $40.00
13706 Metatarsal bone - closed reduction $20.12
13707 Metatarsal bone - closed reduction $7.04
13708 Metatarsal bone - closed reduction $43.23
13610 Minor laceration or foreign body - no anaesthesia $35.84
13611 Minor laceration/foreign body requiring anaes. $66.76
13631 Nail removal - simple $35.75
13632 Nail removal with destruction of nail bed $72.34
13605 Opening superficial abscess, including furuncle - operation only $44.76
13630 Paronychia $35.75
13633 Wedge excision of one nail $63.83

Surgical Assistant Or Second Operator

13052 Anaes. evaluation - non-certified anaesthetist $55.93
13194 Gp first surgical assist of the day $89.09
00193 Non-cvt cert. surgical assist @ open heart surgery $30.89
00196 Surgical assist $317.01 to 529.00 inclusive $189.24
00198 Surgical assist time after 3 hrs - per 15 mins $28.52
00195 Surgical assist-less than $317.00 inclusive $134.22
00197 Surgical assistance - operations over $529.00 $261.76

Telehealth

13338 Community based gp,1st fac visit of day bonus,extr $49.84
13236 Telehealth GP Consultation (age 0-1) $85.40
13436 Telehealth GP Consultation (age 2-49) $77.63
13536 Telehealth GP Consultation (age 50-59) $84.87
13636 Telehealth GP Consultation (age 60-69) $89.28
13736 Telehealth GP Consultation (age 70-79) $100.91
13836 Telehealth GP Consultation (age 80+) $116.11
13238 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 0-1) $62.43
13438 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 2-49) $56.76
13538 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 50-59) $62.05
13638 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 60-69) $65.26
13738 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 70-79) $73.77
13838 Telehealth GP Individual Counselling for a prolonged visit for counselling (age 80+) $85.12
13237 Telehealth GP Visit (age 0-1) $34.90
13437 Telehealth GP Visit (age 2-49) $31.72
13537 Telehealth GP Visit (age 50-59) $31.72
13637 Telehealth GP Visit (age 60-69) $36.47
13737 Telehealth GP Visit (age 70-79) $41.22
13837 Telehealth GP Visit (age 80+) $47.59

Urology

13655 General practice - vasectomy bonus $21.57

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.

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