Alternative Payment Plans

Surgeon preparing for surgery

Alternative Payment Plans

The term “alternative payment plan,” or APP, refers to a type of physician contract that is used by family physicians (in solo or group practice) and some rural specialists. An APP is an alternative to billing fee-for-service or being paid under a clinical/academic funding plan (C/AFP) contract.

Under the 2019 Master Agreement, physicians paid through an Alternative Payment Plan (APP) receive 2% across-the-board increases in each year of the contract. The first-year increase is retroactive to April 1, 2019.

In addition, APP family physicians have the ability to shadow bill the increased 03.03 fees, which will help many reach the 80% and 100% shadow billing thresholds, allowing them to access the 5.6% bonus (and all FFS billings after 100% of the APP contract value has been shadow billed).

Some family physicians paid through an APP will also benefit from $7.3 million invested in a new Blended Capitation Payment Model to support team-based and virtual care, and $2.7 million invested into a new community hospital inpatient program (CHIP) model, for eligible sites.

Under the 2019 Master Agreement, APP specialists can bill fee-for-service for patient care provided during on-call hours. This change is retroactive to Oct. 25, 2019.

Alternative payment plan  contracts are implemented to:

  • Provide physicians with a guaranteed minimum funding level and income stability
  • Facilitate the delivery of efficient and effective medical care that may not be compatible with the fee-for-service funding model
  • Support new models of care, including collaborative care models, to better meet community needs

An APP contract includes a deliverables agreement  agreed upon by the physician (or physicians), as well as representatives of the Department of Health and Wellness (DHW), the Nova Scotia Health Authority (NSHA) and Doctors Nova Scotia.

Physicians on APP contracts are expected to be accountable for the services they deliver. This requires consistent shadow billing and completion of an annual activity report.

Doctors Nova Scotia representatives are available to help physicians who are interested in converting to an APP, as well as new physicians who are considering or being offered an APP arrangement.

Contact your Physician Advisor for assistance with:


Kim Oakley
Senior physician advisor and compensation manager
902-481-4924 (direct)
Jennifer Girard
Physician advisor (Zone 4-Central)
902-481-4912 (direct)
Ryan Brown
Physician advisor (Zones 2-Northern and 3-Eastern)
Noelle Moulaison
Physician advisor (Zone 1-Western)
902-481-4931 (direct)