Effective June 1, 2020: On a temporary basis, Chronic Disease Management fees (14050-53, 14250-53) may now be billed after one year of care if the two required visits were provided by telehealth, and the required face-to-face visit to provide a personal health risk assessment (14066) can now be provided via telehealth. Please visit BC Family Doctors website for more details.
May 25, 2020 update: Doctors of BC and the Government of BC have made fee code changes to support the delivery of virtual care during COVID-19. Please note that the billing guides below do not contain those temporary changes. For a summary of temporary fee code changes for family physicians, please see the BC Family Doctors website.
The following incentive fees are available to BC’s eligible family physicians. The purpose of the fees is to improve patient care. To read the full preamble for the GPSC billing guides, effective January 1, 2021, click here.
For billing inquiries, please e-mail us.
The Community Longitudinal Family Physician (CLFP) Portal Codes (14070, 14071) are zero value codes that should be submitted at the beginning of each calendar year by CLFPs and locums who will cover for them. Many GPSC initiated fees are only billable by physicians who have fulfilled the requirements of, and successfully submitted, 14070/71.
Submitting the 14070 Portal Code signifies that:
- You are a community longitudinal family physician (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 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 the 14071 Locum CLFP Portal Code signifies that you are a locum tenens working on a temporary basis for a CLFP who has submitted 14070 and is away from practice. As per the GPSC Preamble, a locum tenens is defined as a physician with appropriate credentials who substitutes on a temporary basis for another physician who is away from practice.
Effective January 1, 2021, family physicians who have a focused practice in long term care facilities and are not working as a CLFP (as defined in the GPSC Preamble) in a community-based physician office or clinic will not be eligible to submit the CLFP Portal Codes (14070, 14071) and may submit the Long Term Care Portal Code (14072) to access fee codes 14076-78 and 14050-53. Please see the billing guide below for further details.
- CLFP Portal and LTC Portal Billing Guide (14070, 14071, 14072). Effective January 1, 2021.
Chronic Disease Management
Chronic Disease Management fees (14050, 14051, 14052, 14053; 14250, 14251, 14252, 14253) provide funding for FPs to identify, manage and improve care of patients with diabetes, hypertension, chronic obstructive pulmonary disease, and congestive heart failure. The Chronic Disease Management (CDM) fees compensate family physicians for the additional work, beyond the office visit, of providing guideline-informed care to patients with these diagnoses over the course of a full year.
To support team-based care, management of chronic diseases can involve college-certified Allied Care Providers, who may provide one of the visits required for billing CDM fees (14029, 14076, 14276). Please see the billing guide below for further details.
CDM fees 14050-14053 are only billable by family physicians who have submitted the CLFP Portal Codes (14070, 14071) or the Long Term Care Portal Code (14072). See the billing guide below for more information.
Complex Care Planning and Management
Two complex care fees compensate FPs for the time and skill needed to care for patients with eligible complex conditions who would benefit from a care plan.
14033 is payment for developing a care plan and managing patients who have documented confirmed diagnoses of at least two eligible chronic conditions as outlined within the billing guide below. 14075 is payment for developing a care plan and managing the conditions of patients of any age who require assistance with instrumental (IADL) and non-instrumental (NIADL) activities of daily living.
Both 14033 and 14075 are only billable by family physicians who have submitted the CLFP Portal Codes (14070, 14071). For more information, please see the billing guide below.
- GPSC Complex Care Billing Guide (14033, 14075). Effective January 1, 2021.
Conferencing and Telephone Management
The FP conferencing fee (14077) supports collaboration between community family physicians and other physicians or allied care providers. Eligible FPs can bill for two-way synchronous conferencing via telephone or video with other physicians or Allied Care Providers such as nurses about the management of patients. Telephone Advice fees (14018, 14019, 14021, 14022) remunerate FPs for seeking and providing advice to their physician and allied care provider colleagues. FP-to-patient telephone management and two-way relay of physician advice via phone, text or email fees (14023, 14076, 14078) help improve efficiency of care through non face-to-face ‘visits’ or ‘touches’ between the physician or specific delegated staff, and the patient or their medical representative.
14076, 14077 and 14078 are only billable by family physicians who have submitted the CLFP Portal Codes (14070, 14071) or the Long-Term Care Portal Code (14072) or are registered in a Maternity Network or FP Unassigned In-patient Network. For more information, please see the billing guide below.
- GPSC Conferencing and Telephone Management Billing Guide (14077, 14018, 14019, 14021, 14022, 14023, 14076 & 14078). Effective January 1, 2021.
The in-patient care incentives (14086, 14088) recognize the importance of continuous FP-patient relationships including in-patient care and coordination of patient transitions between hospitals and community. The in-patient care incentives promote and support family physicians who participate in the GPSC's In-Patient Initiative by providing in-patient care to their own patients, and those FPs who additionally care for unassigned in-patients.
- GPSC In-Patient Care Billing Guide (14086, 14088).
- GPSC Assigned In-Patient Network Registration Form (14086).
- GPSC Unassigned In-Patient Network Registration Form (14088).
The GPSC Long-term Care Initiative (LTCI) is designed to enable physicians to develop local, scalable, and sustainable solutions to long term care delivery. The initiative supports Divisions of Family Practice (or self-organizing groups of family physicians where no Divisions exist) to design and implement local solutions that deliver dedicated FP MRP services to patients in long term care facilities. In addition to the initiative funding, there are a number of existing GPSC and MSP fees available to support full-service family physicians who provide long term care services.
- The LTC billing summary is currently under review. Please check back for an updated version soon.
The maternity care network incentive (14010) supports family physicians providing full-scope maternity care to patients in their community, to work together. The obstetrical delivery incentives (14004, 14005, 14008, 14009) are intended to encourage family physicians to continue to provide intra-partum obstetrical care as part of their practice.
Obstetrical delivery incentives are only billable by maternity network members or physicians who have submitted the CLFP Portal Codes (14070, 14071). See the billing guide below for further information.
The Mental Health planning (14043) and management fees (14044, 14045, 14046, 14047, 14048) compensate family physicians for the time and skill it takes to work with patients with mental health conditions who would benefit from a care plan. 14043 is payment for developing the care plan to manage the patient’s mental health condition. The MH management fees remunerate FPs for providing counselling visits to these patients beyond the current 4 visits covered by the 0120 series.
Mental health planning and management fees are only billable by physicians who have submitted the CLFP Portal Codes(14070, 14071). See the billing guide below for further information.
- GPSC Mental Health Billing Guide (14043, 14044, 14045, 14046, 14047, and 14048). Effective January 1, 2021.
The palliative care planning fee (14063) supports FPs to take the time required to collaboratively plan and coordinate end-of-life care with their palliative patients.
The palliative care fee is only billable by physicians who have submitted the CLFP Portal codes (14070, 14071). See the billing guide below for further information.
- GPSC Palliative Care Billing Guide (14063). Effective January 1, 2021.
Prevention (Personal Health Risk Assessment)
Family physicians can provide Personal Health Risk Assessment (Prevention) visits with at- risk patients in one of the target populations, which include tobacco use, unhealthy eating, physical inactivity and medical obesity.
The prevention fee is only billable by physicians who have submitted the CLFP Portal codes (14070, 14071). See the billing guide below for further information.
Effective June 1, 2020: On a temporary basis, the required face-to-face visit to provide a personal health risk assessment (14066) can now be provided via telehealth. Please visit BCFD website for more details.