Updated Dec 18, 2020
Initially approved by GPSC in 2019, new rules for family physicians billing codes 14070 and 14071 take effect January 1, 2021. Changes include a new definition for Community Longitudinal Family Physician (CLFP) in the GPSC Preamble. Physicians need to ensure they meet the new rules when billing 14070 and 14071. The new rules can be found below.
Doctors who work in a focused practice in long-term care and who do not work in a community-based longitudinal family practice may no longer meet the eligibility requirements of 14070 or 14071. If this applies to you, there will be a new code for you to bill, 14072, called the Long-Term Care (LTC) Portal, which will be available in early 2021. The new LTC Portal gives access to billing codes 14050-53 (chronic disease management fees) and 14076-78 (telephone, conferencing, and advice relay fees).
Note: Physicians who work in community-based longitudinal family practice in addition to long-term care will not need to bill 14072; they may continue to submit 14070 (or 14071 for locums) provided they meet all the requirements of 14070/71.
If you have any questions, please contact gpsc.billing@doctorsofbc.ca.
Effective January 1, 2021 - New billing requirements for CLFP Portal (14070, 14071)
Submitting fee code 14070 signifies that:
- You are a CLFP, as defined in the GPSC Preamble, with an office from which you provide in-person medical services to a known panel of patients;
- You are the Most Responsible Physician/Provider (MRP) for the majority of the patient’s longitudinal primary medical care, providing continuous comprehensive coordinated family practice services to your patients, and will continue to do so for the duration of that calendar year;
- You are confirming your doctor-patient relationship with your existing patients through a standardized conversation or ‘compact’; and,
- You are able to produce a list of active patients for whom you are the MRP.
Submitting fee code 14071 signifies that:
- You are providing community longitudinal family practice services to the patients of host physicians, and will continue to do so for the duration of any locum coverage for a family physician who has submitted 14070.
Effective January 1, 2021 – New definition of a “Community Longitudinal Family Physician” (CLFP) in GPSC Preamble
For the purpose of GPSC incentives, a family physician is working as a “Community Longitudinal Family Physician” when they do all of the following:
- Assume the role of Most Responsible Physician/Provider (MRP) for a known panel of patients.
- Confirm patient-physician relationship with their patients through a standardized conversation or “compact”, as outlined in PG14070.
- Provide, or coordinate delivery of, longitudinal full scope family medicine primary care services to a patient panel that is inclusive of patients of diverse demographics and medical needs.
- Work in community settings such as physician offices or health care clinics where patients are seen in person. CLFP may also provide some virtual services to their patient panel via telephone, video or other virtual care modality. CLFP may also provide some services to patient panel in facility settings such as hospitals, long-term care, hospices, assisted living, or group homes.
- Maintain the comprehensive longitudinal medical records of each patient on patient panel.
A family physician is NOT considered to be working as a CLFP while they are working solely in one or more of the following health care settings:
- Episodic care settings such as, but not limited to, walk-in clinics, urgent care centres, and hospitals where physician does not assume the role of MRP for patients.
- Virtual care settings where patient care is delivered via telephone, video, or other virtual care modalities.
- Focused practices serving a specific patient population or providing sub-specialty services such as, but not limited to, maternity care, palliative care, sports medicine, chronic pain, and addiction care.
- Facility settings such as, but not limited to, hospitals, long-term care, hospices, assisted living, or group homes.
New Long-Term Care Portal (14072)
Doctors who work in a focused practice in long-term care and who do not work in a community-based longitudinal family practice may no longer meet the eligibility requirements of 14070 or 14071. If this applies to you, there is a new code for you to bill, 14072, called the Long-Term Care (LTC) Portal, which will be available in early 2021. The new LTC portal gives access to:
- 14076 Family Physician Patient Telephone Management Fee
- 14077 Family Physician Conference with Allied Care Provider and/or physician
- 14078 Family Physician Email/Text/Telephone Medical Advice Relay Fee
- 14050, 14051, 14052, 14053 Chronic Disease Management Fees
Note: Physicians who work in community-based longitudinal family practice in addition to long-term care may continue to submit 14070 (or 14071 for locums) provided they meet all the requirements of 14070/71.
Family Physicians working under Alternative Payment/Funding Models
Family physicians who provide services under an Alternative Payment/Funding Model are not eligible to submit 14070 or 14071 for the portion of their medical practice funded by an Alternative Payment/Funding Model. However, family physicians may submit 14070 or 14071 for the portion of their medical practice funded by fee-for-service as long as they meet all the requirements of 14070 or 14071.
As of January 1, 2021, 14029 (FP Allied Care Provider Practice Code) will be no longer require the submission of 14070 or 14071.