At Dr.Bill we’ve noticed that many physicians regularly engage in consultations with other doctors as well as follow-ups with patients via phone or videoconference, yet neglect to bill AHCIP for them.
This adds up to a lot of unpaid work over a year—not to mention a career!
To optimize your medical billing, make sure you submit claims for all eligible telephone and video conference consultations. Many types of virtual consults are eligible for payment from Alberta Health, including:
- Requesting advice from other physicians
- Providing advice to other physicians
- Providing advice to nurse practitioners (NPs) and midwives
- Providing advice to other registered healthcare professionals
- Making follow-up phone calls to patients
See below for the Alberta Health codes and associated values for telephone and videoconference consultations:
Physician to Physician Consults
Both the referring physician (the doctor who initiates a call) and the consultant physician (the doctor who receives the call) can bill for qualifying telephone and video consults.
Note that consultant physicians may bill applicable codes when providing qualifying advice to another physician as well as to a nurse practitioner or midwife.
Referring Physician (requesting advice from another physician)
| Time of Day | Code | Value |
| Weekdays 07:00-17:00 | 03.01LG | $33.92 |
| Evenings 17:00-22:00 & Weekends/Holidays 07:00-22:00 | 03.01LH | $37.15 |
| Nights 22:00-07:00 | 03.01LI | $40.38 |
Notes:
- A maximum of 2 of the above codes may be claimed per patient per day
- May be claimed in addition to visits/other services provided the same day
- May only be claimed when the consultant has provided an opinion and recommendations for patient treatment
- Full guidelines for each code are available in the AMA Fee Navigator®
Consultant Physician (providing advice to a physician, NP or midwife)
| Time of Day | Code | Value |
| Weekdays 07:00-17:00 | 03.01LJ | $77.74 |
| Evenings 17:00-22:00 & Weekends/Holidays 07:00-22:00 | 03.01LK | $115.07 |
| Nights 22:00-07:00 | 03.01LL | $135.81 |
Notes:
- A maximum of 2 of the above codes may be claimed per patient per day
- Advice to NPs may only be claimed when the NP is in an autonomous practice or working at a nursing station where no physician is present
- Advice to midwives may be claimed if the midwife is in independent practice or working at a midwifery centre
- May only be claimed when the consultant has provided an opinion and recommendations for patient treatment
- Full guidelines for each code are available in the AMA Fee Navigator®
Physician to “Other Healthcare Professional” Consults
Physicians may also bill for providing advice to other registered healthcare workers such as paramedics, assisted living staff, active treatment facility workers, long term care workers, hospice workers, home care workers, and public health nurses. In most cases, calls must be initiated by the other healthcare worker.
Consultant Physician (providing advice)
| Time of Day | Code | Value |
| Weekdays 07:00-17:00 | 03.01NG | $17.77 |
| Evenings 17:00-22:00 & Weekends/Holidays 07:00-22:00 | 03.01NH | $21.00 |
| Nights 22:00-07:00 | 03.01NI | $24.23 |
Notes:
- A maximum of 2 of the above codes may be claimed per patient per day
- May only be claimed when the consultant has provided an opinion and recommendations for patient treatment
- Full guidelines for each code are available in the AMA Fee Navigator®
Physician to Patient Follow Up Calls
Physicians are eligible to bill AHCIP for telephone calls placed directly to patients to discuss patient management/diagnostic test results. Calls may be claimed in addition to visits or other services provided on the same day (make sure you use different encounter numbers for the visit and the call). Note that voicemails may not be claimed.
(Looking for virtual care-related billing codes for patient visits and assessments? Consult the AMA’s list of virtual care billing codes.)
Physician to Patient Follow Up Calls
| Code | Value |
|---|---|
| 03.05JR | $20.00 |
Notes:
- A maximum of 14 telephone calls may be claimed per physician, per calendar week
- May be claimed in addition to visits/other services provided the same day
- May be claimed when speaking with the patient and also the parent or guardian of a pediatric patient, the primary caregiver of a patient with mental health concerns or an agent as defined by the Personal Directives Act
- Full guidelines for each code are available in the AMA Fee Navigator®
Questions About Billing for Phone & Video Consults?
Contact a Dr.Bill AHCIP billing specialist for more information on how to apply these codes and optimize your billing.
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