General Practice BILLING GUIDE - British Columbia Medical ...

A GP SERVICES COMMITTEE INCENTIVES
2. CONFERENCING FEES (14015 AND 14016)
These new payments (14015 and 14016) are for case conferencing for complex
patients who are facility-based or community-based. Under the 2006 agreement they
are limited to the care of BC patients (out-of-province patients are not eligible) who
fall into five categories:
• frail elderly; diagnostic code V15
• palliative care; diagnostic code V58
• end of life; diagnostic code V58
• mental illness; appropriate mental health diagnostic codes
• patients of any age with multiple medical needs or complex co-morbidity
(two or more distinct but potentially interacting problems where care needs
to be coordinated over time between several health disciplines); diagnostic
code of one of the major disorders but at some future date, both will be
required
See table 1 below for a more complete description of the eligible patient populations.
Eligibility
These incentive payments to improve patient care are available to:
• all general practitioners who have a valid BC Medical Services Plan (MSP)
practitioner number (registered specialty 00); practitioners who have billed
any specialty fee in the previous 12 months are not eligible; and
• whose majority professional activity is in full-service family practice; and
• who are considered the most responsible general practitioner for the
patients at the time of service.
These payments are not available to physicians who are employed by or who are under
contract with a facility or health authority who would otherwise have attended the
conference as a requirement of their employment or contract. They are also not
available for physicians working under salary, service contract, or sessional arrangements
who would otherwise have attended the conference as a requirement of their
contract.
These payments are payable at a rate of $40 per 15 minutes or greater portion
thereof. They are payable in addition to payment for a medically required visit if the
conferencing requirements are done on the same day as a visit provided the visit
occurs before or after the conference. There is a maximum of 6 units (90 minutes)
payable per calendar year per patient, with a maximum of 4 units (1 hour) on any
single day. The claim must state start and end times of the service.
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GENERAL PRACTICE BILLING GUIDE