July 29, 2020

To support COVID-19 risk mitigation, temporary changes have been made to fee item 00039 (Management of Maintenance Opioid Agonist Treatment (OAT) for Opioid Use Disorder). These changes will allow physicians to bill an appropriate visit fee in addition to fee item 00039 when visits are done for substance use risk mitigation during the pandemic. The changes are effective July 23, 2020, with the end date to be determined by the Provincial Health Officer.

00039: Management of Maintenance Opioid Agonist Treatment (OAT) for Opioid Use Disorder

Notes: Temporary changes noted in red.

  1. The physician does not necessarily have to have direct face-to-face contact with the patient for this fee to be paid.
  2. 00039 is not the only fee payable for any medically necessary service associated with maintenance opioid agonist treatment for opioid use disorder. This includes but is not limited to the following:
    • At least one visit (in-person, telephone or video conference) per month with the patient after induction/stabilization on opioid agonist treatment is complete.
    • At least one in-person visit with the patient every 90 days. Exception to this criterion will be considered on an individual basis.
    • Supervised urine drug screening and interpretation of results.
    • Simple advice/communication with other allied care providers involved in the patients OAT.
  3. Claims for treatment of co-morbid medical conditions, including psychiatric diagnoses other than substance use disorder, are billable using the applicable visit or service fees. Counselling and visit fees related only to substance use disorder are not payable in addition with the exception of visits required to support Substance Use Risk Mitigation in the context of COVID-19 (claim note record must indicate “COVID-19 risk mitigation”).
  4. This fee is payable once per week per patient regardless of the number of services per week for management of OAT maintenance.
  5. This fee is not payable with out of office hours premiums.
  6. Eligibility to submit claims for this fee item is limited to physicians who are actively supervising the patient’s continuing use of opioid agonist medications for treatment of opioid use disorder.
  7. This payment stops when the patient stops opioid agonist treatment.              

For additional details please visit the BC Family Doctors website.

For billing inquiries, please e-mail us.