There have been new updates and changes to GPSC fee codes. These changes are all effective from March 20th and March 23rd. See below for more details or the original message from GPSC.
Effective March 23, 2020 (until further notice):
GPSC Planning Fees 14033 Complex Care, 14075 Frailty, 14043 Mental Health, 14063 Palliative Care
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All face-to-face planning required under the GPSC planning fees may now be provided by Telehealth: video or phone. Think of it as physician:patient planning.
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The existing time and documentation requirements will not change: total planning time (30 minutes) and physician:patient planning time (minimum 16 minutes).
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If medically indicated, a telehealth visit (13037) may be billed in addition. The time spent on this visit cannot be concurrent with the physician:patient planning time.
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Submit the appropriate planning fee code and include a note in the claim stating “service provided via Telehealth.”
GPSC Mental Health Management Fees 14044, 14045, 14046, 14047, 14048
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Mental Health Management fees currently allow videoconferencing. This has been expanded to include telephone counselling.
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Submit the appropriate MH management fee code with a claim note record: service provided via Telehealth.
GPSC CDM fees 14050, 14051, 14052, 14053
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No changes have been made to the CDM fees. Existing rules already allow one of the two required visits in the previous 12 months to be provided by Telehealth – video or phone.
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This will be reviewed in the future if the pandemic situation continues.
GPSC Prevention fee 14066
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No changes have been made to allow this service to be provided by Telehealth.
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This will be reviewed in the future if the pandemic situation continues.
Effective March 20, 2020 (until further notice):
Long Term Care Facility Visit 00114
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If the patient is able to independently use a phone and you feel that the encounter could be appropriately provided by Telehealth (video or telephone), then you’re able to bill 00114 face to face Long Term Care facility. Leave a note in the notes field of your claim stating ‘service provided via Telehealth.’
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If the patient cannot independently use a phone (e.g. due to dementia, hearing loss etc.) or does not have their own phone, you may review the patient’s medical status and any problems by telephone with an RN/LPN at March 25, 2020 the LTC facility, and bill the visit using 00114 and include the a note in the claim stating “Service provided via Telehealth with RN/LPN.
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13334 LTC First visit of the day bonus is not billable with 00114 when provided via Telehealth.
Palliative Care Patient Facility visit 00127
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If the patient is able to independently use a phone and you feel that the encounter could be appropriately provided by Telehealth (video or telephone), then bill 00127 and include a note in the claim stating “service provided via Telehealth.”
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If the patient cannot independently use a phone or does not have their own phone, you may review the patient’s medical status and any problems by telephone with an RN/LPN where the palliative care is provided, and bill the visit using 00127 and include a note in the claim stating “Service provided via Telehealth with RN/LPN.
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13338 First visit of the day bonus is not billable with 00127 when provided via Telehealth.
If, at any time, you have any questions regarding the available fee codes, or under what situation you can use them, don’t hesitate to get in touch. We’ve extended our support hours and
are here to help. Please check back to the COVID-19 Resource centre for more updates. For more on virtual care check out our Virtual Care Guide during COVID-19. For more on virtual care check out our Virtual Care Guide during COVID-19.
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.
