Did you know there are numerous GPSC incentive payments available to eligible BC family physicians? These payments cover various areas from in-patient care to mental health, and even expenses such as conferencing and phone management. The purpose of the incentive payments is to improve patient care, no matter what your patients’ needs may be.
Today we’re covering two of these incentives, the obstetrical delivery and maternity network incentives that encourage family physicians to continuously provide intra-partum obstetrical care as part of their practice. So, if you’re a family physician providing obstetrical and full-scope maternity care to patients in your community, mostly by collaborating with other GPs, you may qualify for the GPSC Maternity Network incentives below.
What You Need to Know:
The GP Obstetric Delivery Incentive
The Maternity Network incentives program provides an incentive payment for GP Obstetric Delivery. If you’re eligible then you can use the following incentive fee codes with the corresponding 141 Obstetric codes.
Eligibility Rules & Notes:
14004 Obstetric Delivery Incentive for Full Service General Practitioner – associated with vaginal delivery and postnatal care: $288.77
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Payable only if you’re the family physician who provides the maternity care and you’re the one responsible for, or shares the responsibility for, providing the patient’s General Practice medical care.
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Payable only when billed with 14104.
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Maximum of one incentive, per patient delivered, under 14004, 14008, 14009.
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Maximum of 25 incentives per calendar year per physician under fee item 14004, 14005, 14008, 14009 or a combination of these items.
14005 Obstetric Delivery Incentive for Full Service General Practitioner – associated with management of labour and transfer for delivery to a higher level of care facility: $120.26
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Payable only if you’re the family physician who provides the maternity care and you’re the one responsible for, or shares the responsibility for, providing the patient’s General Practice medical care.
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Payable only when billed with 14105.
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Payable in addition to 14004 or 14009 when billed and paid to a different GP attending delivery in the receiving hospital.
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Maximum of 25 incentives per calendar year per physician under fee item 14004, 14005, 14008, 14009 or a combination of these items.
14008 Obstetric Delivery Incentive for Full Service General Practitioner – associated with postnatal care after elective caesarean-section: $59.41
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Payable only if you’re the family physician who provides the maternity care and you’re the one responsible for, or shares the responsibility for, providing the patient’s General Practice medical care.
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Payable only when billed with 14108.
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Maximum of one incentive per patient delivered.
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Maximum of 25 incentives per calendar year per physician under fee item 14004, 14005, 14008, 14009 or a combination of these items.
14009 Obstetric Delivery Incentive for Full Service General Practitioner – associated with attendance at delivery and postnatal care associated with emergency caesarean section: $240.54
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Payable to the family physician who provides the maternity care and is responsible for or shares the responsibility for providing the patient’s General Practice medical care.
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Payable only billed with 14109.
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Maximum of one incentive per patient delivered.
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Maximum of 25 incentives per calendar year per physician under fee item 14004, 14005, 14008, 14009 or a combination of these items.
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The Maternity Network Incentive
The Maternity Network is a quarterly payment that GPs can receive to help cover the costs of group/network activities for their shared care of obstetric patients (both assigned and unassigned obstetric patients).
Note: Maternity patients who have been referred to an FP for prenatal care and delivery are not considered unassigned.
14010 Maternity Network – to cover the costs of group/network activities for the shared care of obstetric patients (both assigned and unassigned obstetric patients): $2,100 per quarter ending March 31, June 30, September 30 and December 31.
To bill the quarterly Maternity Network incentive you need to create a claim with the following information:
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Billing amount: $2,100
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PHN: 982487052
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Patient last name: Maternity
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Patient first name/initial: G
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Date of birth: November 2, 1989
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Diagnostic code: V26
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For date of service use: Last day in a calendar quarter
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Billing schedule: Last day of the month, per calendar quarter
Note: At Dr. Bill we have a reminder set-up so you know exactly when to bill it.
Eligibility Rules & Notes:
For the complete 3-month period up to the payment date, you must:
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Be a general practitioner actively practicing in BC.
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Have hospital privileges to provide obstetrical care.
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Provide maternity care and be responsible, or share responsibility, for providing the patient’s general practice medical care – in addition to being paid the delivery fee items 14104, 14105, 14108 and 14109 for the patient.
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Be associated and registered with a minimum of three other network members (special consideration will be given for hospital communities with fewer than four physicians providing maternity care).
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Cooperate with other members of the network so that one member is always available for deliveries.
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Make patients aware of the members of the network and the support specialists available for complicated cases.
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Accept a reasonable number of referrals of pregnant patients from physicians who do not have hospital privileges to deliver babies (preferred first visit to the physician planning to deliver the baby is no later than 12 weeks of pregnancy; the referring physician may, with the agreement of the delivering physician, provide a portion of the prenatal care).
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Share prenatal records (real or virtual) with other members of the network as it makes sense, with the expectation to work toward utilizing an electronic prenatal record.
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Schedule at least four deliveries in each six-month period of time (April to September, October to March)
GP Unassigned Inpatient Care Fee 14088
As part of the GPSC In-patient Initiative, if you’re a member of the Maternity Networks (see below on how to join) then you’re able to bill the Unassigned In-patient care 14088 for unassigned pregnant patients when you’re the Most Responsible Physician (MRP).
14088 GP Unassigned Inpatient Care Fee: $150.00
This fee is restricted to Family Physicians actively participating in the GP Unassigned Inpatient Care or the GP Maternity Networks. It’s billable through the MSP Teleplan system and is payable in addition to the visit fee code (00109, 13109, 13008, 00127, 14088) or the delivery fee.
Eligibility Rules & Notes:
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Payable only if you’re a Family Physician who has submitted a completed GP Unassigned Inpatient Care Network Registration Form and /or a GP Maternity Network Registration Form.
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Payable only if you’re the Family Physician who is the Most Responsible Physician (MRP) for the patient during the in-hospital admission.
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Payable once per unassigned patient per in-hospital admission in addition to the hospital visit (00109, 13109, 13008, 00127) or delivery fee.
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Not payable if you’re employed or if under your contact these duties are covered.
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Not payable if you work under a salary, service contract or sessional arrangements since your duties would also include provision of this care.
Keep in mind, if you’ve billed any specialty consultation fee in the previous 12 months, it automatically makes you not eligible.
How to enroll in the Maternity Network Incentives
You can fill out the Maternity Network Registration form electronically through Dr. Bill. You can also print it and submit it by email to GPSCregistration@gov.bc.ca.
This will register you to bill the GP Obstetric Delivery fee codes along with the quarterly Maternity Network incentive.
Related Maternity Network Fee Codes
14077: GP attachment patient conference fee.
Billing Amount: $40.00 per 15 minutes.
14019: Gp advice fee to np-telephone or in person
Billing Amount: $40.00.
14076: GP attachment telephone management fee
Billing Amount: $20.00.
14078: GP email/text/telephone medical advice relay fee
Billing Amount: $7.00.
Remember, if you’re a family physician providing obstetrical and full-scope maternity care to patients in your community, you may be eligible for the GPSC Maternity Network incentive payments above.
This is just one incentive program for BC family physicians, among many, offered by the GPSC. The payments are an important part of helping physicians and health care workers improve the overall care of patients throughout BC. If you have questions about these incentives or anything MSP related, don’t hesitate to get in touch.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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