New fee codes take effect upon signing of the new Physician Agreement, however, MSI will not be ready to receive claims for the new codes until Sept. 15, 2023. It is recommended that physicians hold billing claims until Sept. 15 so they can claim these new codes. The new fee codes are:
- New patient intake visits
- Prolonged office visit for ME=CARE patients
- Prolonged nursing home visits
- Telephone prescription renewals
- Allied health-care provider to physician
- 03.09 K and L specialist advice codes (expanded to include in-person and secure messaging exchanges between consulting and referring physicians)
- GPEW (25% premium) for after-hours service – family physicians are now able to bill the GPEW regardless of whether they have billed ME=CARE for the service. This includes physicians delivering services in walk-in clinics.
An important note about multiples
Details on the new fee codes are outlined on pages 29 to 34 of the Physician Agreement, however, the language on the Prolonged Office Visits does not fully reflect our final agreement with the DHW. We have agreed that the multiple is billable at 24 minutes. For a physician to claim multiples, they would need to spend 80% of the total time in direct patient care (during a 30-minute visit, 24 minutes must be in direct patient care). If the 24-minute mark was not reached with the patient, the physician would claim a regular visit (with no multiples). The government has, in turn, agreed that 03.03A geriatric visits will now be able to be billed with multiples at the same enhanced rate as the 03.03A base visit (despite language in the Physician Agreement that says multiples on 03.03A can only be billed at the regular 03.03 rate).
Fee Committee to-do list
Under the 2023 Physician Agreement, the Fee Committee will explore several fee codes that better compensate physicians for the work they are doing or recognize work that is currently not compensated appropriately, including:
- Physician-to-physician capacity building, mentoring, maintenance of competency
- NSH/IWK Health–requested quality/safety work
- Collaboration time
- Team development
- Family physician consults
- Group medical visits
- Multiples on specialist telephone advice
- Triage
- Shared care/co-management of patients (for example, high-risk obstetrics rounds, organ transplant rounds)
- General internal medicine visit and consult codes (including complex discharge, follow-up office visit and subsequent hospital visit)
- Care of the elderly
- Long-term care
- End-of-life care