Virtual care services account for most new provincial and territorial physician billing codes created in response to the COVID-19 pandemic

July 3, 2020 — In response to the COVID-19 pandemic, provincial and territorial governments and medical associations moved rapidly to adapt the physician fee schedules to meet the emerging needs of physicians and their patients during the crisis, especially for virtual care services.

CIHI has monitored changes to the fee schedules, which include new billing codes, modified fees, updated practice guidelines designed to support public health measures, income stabilization and several other modifications. Each jurisdiction in Canada has implemented some of these changes, and many similarities exist from one jurisdiction to the next.

In most cases, the codes are temporary and will exist for the duration of the pandemic. The exception is Alberta, which recently announced that the COVID-19 codes will be a permanent feature of its fee schedule. CIHI will continue to monitor the fee schedules on a monthly basis and will update the information in the table as it changes.

The information below is current as of June 8, 2020.

Newfoundland and Labrador

Effective date: March 13, 2020

•    50000 Pandemic Virtual Care Assessment (telephone or patient videoconferencing)

Further reading

Government of Newfoundland and Labrador External link, opens in new window

Prince Edward Island

Effective date: March 16, 2020

Physicians may provide the following services by telephone during the COVID pandemic:

  • xx13 — Limited Office Visit
  • 2505 — Health Promotion Counseling
  • 2501 or 2504 — Psychotherapy
  • 2588 or 2586 or 2886 — Diagnostic and Therapeutic Interview 
  • xx60 — Consultation
  • xx62 — Repeat Consultation
  • 2863 — Geriatric Follow-Up Visit
  • 0705 — Postnatal Visit
  • xx10 — For specialists’ use only: Comprehensive Office Visit for patients who have been initially referred for consultation and subsequent visits for the same diagnosis

Note

xx represents a placeholder that corresponds to the physician’s specialty.

Further reading

Medical Society of Prince Edward Island (MSPEI) External link, opens in new window

Nova Scotia

Effective date: March 13, 2020

  • 03.03X — Telephone and telehealth management for presumptive/confirmed COVID-19 as well as routine/interval care during pandemic

All office-based services, except procedural services, that usually occur face-to-face may also be provided by telephone, telehealth network or an approved virtual care platform.

Further reading

Nova Scotia Medical Insurance (MSI) External link, opens in new window

New Brunswick

Effective date: March 13, 2020

  • 1 — For patients with diagnosed or suspected COVID-19 (indicate “COVID-19” in the diagnostic field)
  • 859 — For all other virtual care that can be provided in place of face-to-face services
  • 331 and 332 — Psychiatrists are permitted to bill these fee codes for services performed by telephone.

Further reading

Vitalité Health Network External link, opens in new window

Quebec

Effective date: March 16, 2020

Physicians bill existing services when delivered by telephone or video conference. 

Physicians working in designated facilities may also bill for their services in a variety of ways. 

For family physicians, the following fee code exists:

  • 19860 — Hourly tariff for providing services in a COVID-19–designated clinic (non-traditional site, or NTS).

For specialist physicians, the following fee codes have been introduced:

Cohort care unit, non-ambulatory NTS or hospitalization

  • 15923 — Main visit (visite principale) in connection with COVID-19
  • 15924 — Follow-up visit (visite de suivi) in connection with COVID-19.

Influenza clinic, ambulatory NTS or outpatient clinic

  • 15925 — Main visit (visite principale) in connection with COVID-19
  • 15926 — Follow-up visit (visite de suivi) in connection with COVID-19

Further reading

Family physicians External link, opens in new window

Specialist physicians External link, opens in new window

Ontario

Effective date: March 14, 2020

  • K080 — Minor assessment of patient by telephone or video
  • K081 — Intermediate assessment including psychotherapy by telephone or video
  • K082 — Psychotherapy, psychiatric or mental health counselling by telephone or video
  • K083 — Specialist consultation by telephone or video
  • K087 — Minor assessment of an uninsured by telephone or video
  • K088 — Intermediate assessment of an uninsured patient including psychotherapy by telephone or video
  • K089 — Psychotherapy, psychiatric or mental health counselling by telephone or video for an uninsured patient
  • H409 — COVID-19 sessional unit per 1-hour period or major portion thereof (for all insured services rendered in an eligible assessment centre)
  • H410 — COVID-19 sessional unit per 1-hour period or major portion thereof on Saturdays, Sundays, holidays or Monday to Friday afterhours (5 p.m. to 7 a.m.).

Further reading

Ontario Ministry of Health/Ministry of Long-Term Care External link, opens in new window

Manitoba

Effective date: March 14, 2020

  • 8321 — May be billed by all specialties for virtual assessments conducted by telephone or video

Effective date: April 1, 2020

  • 8533 — May be billed by psychiatrists for virtual psychotherapy

Effective date: April 24, 2020

  • 8527 — Chronic care virtual visit by telephone or video
  • 8538 — Virtual consultation by telephone or video
  • 8521 — Virtual consultation by telephone or video, involving a child or geriatric patient, by a psychiatrist
  • 8786 — Virtual psychiatric care by telephone or video
  • 8655 — Virtual psychotherapy by telephone or video

Further reading

Manitoba Health, Seniors and Active Living External link, opens in new window

Saskatchewan

Effective date: March 24, 2020

  • 510A — Pandemic Telephone Assessment
  • 515A — Pandemic Video Assessment
  • 350A — Pandemic Virtual Care: Specialist consultation provided via telephone — first 30 minutes of direct physician–patient care or major part thereof
  • 351A — Pandemic Virtual Care: Specialist consultation provided via secure video conference — first 30 minutes of direct physician–patient care or major part thereof
  • 352A — Pandemic Virtual Care: Specialist consultation provided via telephone or secure video conference — each subsequent 15 minutes of direct physician–patient care or major part thereof, bill units (to a maximum of 2 additional units)
  • 356A — Pandemic Virtual Care: Psychotherapy and other psychiatric services provided via telephone — first 15 minutes
  • 357A — Pandemic Virtual Care: Psychotherapy and other psychiatric services provided via secure video conference — first 15 minutes
  • 358A — Pandemic Virtual Care: Psychotherapy and other psychiatric services provided via telephone secure video conference — each subsequent 15 minutes or major portion thereof, bill units (to a maximum of 7 additional units per patient/per day)

Further reading

eHealth Saskatchewan External link, opens in new window

Saskatchewan Medical Association External link, opens in new window

Alberta

Effective date: March 12, 2020

  • 03.01AD — Telephone advice to a patient or their agent (previously used specifically for the H1N1 virus; has been updated to be applicable during a viral pandemic)

Effective date: March 17, 2020

  • 03.03CV — Assessments provided by general practitioners (GPs) and specialists via telephone or secure video conference.
  • 03.03FV — Follow-up assessments (visits), for referred patients only, provided by specialists via telephone or secure video conference
  • 03.08CV — Comprehensive consultations provided via telephone or secure video conference 
  • 08.19CX — Comprehensive psychiatric consultation provided via telephone or secure video conference 
  • 08.19CV — Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure video conference by a psychiatrist or a generalist of mental health
  • 08.19CW — Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure video conference by a GP and pediatrician

Further reading

Government of Alberta External link, opens in new window

British Columbia

Effective date: March 17, 2020

  • T13701 — Office Visit for COVID-19 with test
  • T13702 — Office Visit for COVID-19 without test

Effective date: March 27, 2020

  • T13706 — FP Delegated Patient Telehealth Management Fee (similar to G14076)
  • T13707 — FP Email/Text/Telephone Medical Advice Relay or ReRX Fee (similar to G14078)
  • T13708 — FP COVID-19 Communication With Specialist and/or Allied Care Provider (a new fee code)
  • T10008 — Urgent Specialist COVID-19 Advice Fee (similar to G10001)
  • T10007 — Specialist Email/Text/Telephone Medical Advice Relay or ReRX Fee (a new fee code)

Effective date: April 15, 2020

  • T10000 — Urgent Specialist Advice on patient with previous visit/service fee (similar to G10001)
  • T10009 — Non-Urgent Specialist Advice on patient with previous visit/service fee (similar to G10002)

Effective date: June 1, 2020

  • T13236 — Telehealth GP Consultation (age 0–1
  • T13436 — Telehealth GP Consultation (age 2–49)
  • T13536 — Telehealth GP Consultation (age 50–59)
  • T13636 — Telehealth GP Consultation (age 60–69)
  • T13736 — Telehealth GP Consultation (age 70–79)
  • T13836 — Telehealth GP Consultation (age 80+)
  • T13237 — Telehealth GP Visit (age 0–1)
  • T13437 — Telehealth GP Visit (age 2–49)
  • T13537 — Telehealth GP Visit (age 50–59)
  • T13637 — Telehealth GP Visit (age 60–69)
  • T13737 — Telehealth GP Visit (age 70–79)
  • T13837 — Telehealth GP Visit (age 80+)
  • T13238 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 0–1)
  • T13438 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 2–49)
  • T13538 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 50–59)
  • T13638 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 60–69)
  • T13738 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 70–79)
  • T13838 — Telehealth GP Individual counselling for a prolonged visit for counselling (minimum time per visit: 20 minutes) (age 80+)

Further reading

MSC Payment Schedule External link, opens in new window

Yukon

All Yukoners now have the option to have their regular doctor’s appointment by phone or virtual health, using the doxy.me platform. This action is in response to COVID-19 and supports Yukoners while physical distancing.

Further reading

Government of Yukon External link, opens in new window

Northwest Territories

Virtual care services are available to all Northwest Territories residents in an effort to maintain public health guidelines. No specific details on fee codes are available.

Further reading

Northwest Territories Health and Social Services Authority External link, opens in new window

Nunavut

Nunavut residents can access telehealth services with facilities in Ontario, Manitoba, the Northwest Territories and Nunavut.

Further reading

Government of Nunavut External link, opens in new window