MSP Billing Codes
Specialty: Family Medicine
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Code | Description | Anes | Fee |
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Chronic Disease Management Incentives |
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14253 | Gp annual chronic care incentive(encounter)-copd | 0 | $125.78 |
14250 | Gp annual chronic care incentive(encounter)-diabet | 0 | $125.78 |
14251 | Gp annual chronic care incentive(encounter)-heart | 0 | $125.78 |
14252 | Gp annual chronic care incentive(encounter)-hypert | 0 | $50.31 |
Community Based GP Hospital Visits |
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13339 | Com based gp,1st hosp visit of day bonus, extra | 0 | $49.84 |
13008 | Community based gp: hospital visit | 0 | $54.20 |
13011 | Community based gp: hospital visit | 0 | $64.64 |
13012 | Community based gp: hospital visit | 0 | $43.23 |
13228 | Community based gp: hospital visit | 0 | $30.09 |
13028 | Community based gp: supportive care hosp visit | 0 | $36.01 |
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Complete Examinations |
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12101 | In office (age 0-1)-complete examination | 0 | $76.83 |
00101 | In office (age 2-49)-complete examination | 0 | $69.85 |
15301 | In office (age 50-59)-complete examination | 0 | $76.83 |
16101 | In office (age 60-69)-complete examination | 0 | $80.32 |
17101 | In office (age 70-79)-complete examination | 0 | $90.80 |
18101 | In office (age 80+)-complete examination | 0 | $104.79 |
12201 | Out of office (age 0-1)-complete examination | 0 | $92.20 |
13201 | Out of office (age 2-49)-complete examination | 0 | $83.82 |
15201 | Out of office (age 50-59)-complete examination | 0 | $92.20 |
16201 | Out of office (age 60-69)-complete examination | 0 | $96.39 |
17201 | Out of office (age 70-79)-complete examination | 0 | $108.95 |
18201 | Out of office (age 80+)-complete examination | 0 | $125.74 |
Consultations / Visits |
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13109 | Community based gp:acute care hospital admission | 0 | $103.16 |
14016 | Community patient conference fee-general practice | 0 | $40.00 |
00117 | Ecg interpretation only g.p. | 0 | $10.41 |
14015 | Facility patient conference-general practice | 0 | $40.00 |
14017 | General practice acute care discharge conference | 0 | $40.00 |
14019 | Gp advice fee to np-telephone or in person | 0 | $43.23 |
14078 | Gp email/text/telephone medical advice relay fee | 0 | $7.04 |
14079 | Gp telephone/email management fee | 0 | $15.00 |
14018 | Gp urgent telephone conference with a specialist | 0 | $43.23 |
14023 | Gp with spec training tele patient mgmt-follow up | 0 | $20.12 |
14021 | Gp with specialty training tele advice - urgent | 0 | $60.37 |
14022 | Gp with specialty training tele patient mgmt 1 wk | 0 | $43.23 |
13015 | Hiv/aids primary care mgmt - per 1/2 hr or | 0 | $85.95 |
00103 | Home visit - call placed between 0800 and 2300hrs | 0 | $116.09 |
15310 | In office (age 50-59)-consultation | 0 | $85.40 |
13070 | In office assessment in assoc with a wsbc service | 0 | $16.49 |
13075 | In office assessment in assoc with an icbc service | 0 | $16.49 |
17110 | In office: (age 70-79)-consultation | 0 | $100.91 |
18110 | In office: (age 80+)-consultation | 0 | $116.11 |
00110 | In office: age 2-49-consultation | 0 | $77.63 |
12110 | In office:(age 0-1)-consultation | 0 | $85.40 |
16110 | In office:(age 60-69)-consultation | 0 | $89.28 |
00113 | On call, on site hospital visit - evening | 0 | $51.93 |
00105 | On call, on site hospital visit - night | 0 | $72.17 |
00123 | On call, on site hospital visit - sat, sun or hols | 0 | $51.93 |
12210 | Out of office (age 0-1)-consultation | 0 | $102.48 |
13210 | Out of office (age 2-49)-consultation | 0 | $93.16 |
15210 | Out of office (age 50-59)-consultation | 0 | $102.48 |
16210 | Out of office (age 60-69)-consultation | 0 | $107.14 |
17210 | Out of office (age 70-79)-consultation | 0 | $121.10 |
18210 | Out of office (age 80+)-consultation | 0 | $139.76 |
13005 | Phone call (advice about patient in community care) | 0 | $18.28 |
00116 | Special in-hospital, consultation | 0 | $164.96 |
13000 | Telephone advice in first nations communities | 0 | $18.28 |
12200 | Visit - out of office (age 0 - 1) | 0 | $41.87 |
13200 | Visit - out of office (age 2-49) | 0 | $38.07 |
16200 | Visit - out of office (age 60-69) | 0 | $43.87 |
17200 | Visit - out of office (age 70-79) | 0 | $49.48 |
18200 | Visit - out of office (age 80+) | 0 | $57.09 |
12100 | Visit in office (age 0-1) | 0 | $34.90 |
00100 | Visit in office (age 2 - 49) | 0 | $31.72 |
15300 | Visit in office (age 50-59) | 0 | $34.90 |
16100 | Visit in office (age 60-69) | 0 | $36.47 |
17100 | Visit in office (age 70-79) | 0 | $41.22 |
18100 | Visit in office (age 80+) | 0 | $47.59 |
15200 | Visit out of office (age 50-59) | 0 | $41.87 |
00112 | Visit, emergency | 0 | $116.09 |
00111 | Visit, emergency home | 0 | $117.46 |
Counselling - Group |
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00122 | Group counselling-2nd hour/per half or major part | 0 | $80.50 |
00121 | Group counselling-first full hour | 0 | $160.99 |
13020 | Telehealth general practitioner assistant | 0 | $43.23 |
13036 | Telehealth gp in-office consultation | 0 | $82.43 |
13042 | Telehealth gp in-office group counselling - 2nd hr | 0 | $43.50 |
13041 | Telehealth gp in-office group counselling/1st hr | 0 | $86.94 |
13038 | Telehealth gp in-office individual counselling | 0 | $58.90 |
13037 | Telehealth gp in-office visit | 0 | $34.44 |
13016 | Telehealth gp out of office consultation | 0 | $109.02 |
13021 | Telehealth gp out of office group counsel 1st hour | 0 | $87.46 |
13022 | Telehealth gp out of office group counsel 2nd hour | 0 | $43.76 |
13018 | Telehealth gp out of office individual counselling | 0 | $75.32 |
13017 | Telehealth gp out of office visit | 0 | $41.10 |
Counselling - Individual |
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12220 | Individual counselling - out of office (age 0 - 1) | 0 | $74.90 |
13220 | Individual counselling - out of office (age 2-49) | 0 | $68.09 |
16220 | Individual counselling - out of office (age 60-69) | 0 | $78.31 |
17220 | Individual counselling - out of office (age 70-79) | 0 | $88.54 |
18220 | Individual counselling - out of office (age 80 +) | 0 | $102.15 |
19100 | Individual counselling - out of office (age 80 +) | 0 | $185.00 |
19101 | Individual counselling - out of office (age 80 +) | 0 | $185.00 |
19102 | Individual counselling - out of office (age 80 +) | 0 | $83.00 |
19103 | Individual counselling - out of office (age 80 +) | 0 | $55.00 |
19104 | Individual counselling - out of office (age 80 +) | 0 | $43.00 |
19105 | Individual counselling - out of office (age 80 +) | 0 | $43.00 |
12120 | Individual counselling in office (age 0 - 1) | 0 | $62.43 |
00120 | Individual counselling in office (age 2-49) | 0 | $56.76 |
15320 | Individual counselling in office (age 50-59) | 0 | $62.43 |
16120 | Individual counselling in office (age 60 - 69) | 0 | $65.26 |
17120 | Individual counselling in office (age 70-79) | 0 | $73.77 |
18120 | Individual counselling in office (age 80+) | 0 | $85.12 |
15220 | Individual counselling out of office (age 50-59) | 0 | $74.90 |
Facility Visits |
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00109 | Acute care hospital admission visit | 0 | $81.61 |
00108 | Hospital visit | 0 | $31.93 |
13334 | Ltc facility visit-first visit of day bonus,extra | 0 | $49.84 |
00115 | Nursing home visit - 1 patient when specially call | 0 | $116.45 |
00128 | Supportive care hospital visit | 0 | $27.52 |
00127 | Terminal care facility visit | 0 | $54.20 |
00114 | Visit nursing home one or multiple patients | 0 | $36.54 |
GP For Me Attachment Fees |
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14075 | Gp attachment complex care management fee | 0 | $316.95 |
14077 | Gp attachment patient conference fee | 0 | $43.23 |
14076 | Gp attachment telephone management fee | 0 | $20.12 |
14074 | Gp unattached complex/high needs patient attachmen | 0 | $200.00 |
GPSC Annual Bonuses |
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14033 | Annual complex care management fee | 0 | $316.95 |
14041 | Annual complex care management fee | 0 | $15.00 |
14050 | Gp annual chronic care bonus - diabetes mellitus | 0 | $125.78 |
14051 | Gp annual chronic care bonus - heart failure | 0 | $125.78 |
14052 | Gp annual chronic care bonus - hypertension | 0 | $50.31 |
14053 | Incentive for gp annual chronic care bonus copd | 0 | $125.78 |
Group Medical Visits |
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13770 | General practice group medical visit - 10 patients | 0 | $12.06 |
13771 | General practice group medical visit - 11 patients | 0 | $10.56 |
13772 | General practice group medical visit - 12 patients | 0 | $9.93 |
13773 | General practice group medical visit - 13 patients | 0 | $9.20 |
13774 | General practice group medical visit - 14 patients | 0 | $9.03 |
13775 | General practice group medical visit - 15 patients | 0 | $8.66 |
13776 | General practice group medical visit - 16 patients | 0 | $8.41 |
13777 | General practice group medical visit - 17 patients | 0 | $8.06 |
13778 | General practice group medical visit - 18 patients | 0 | $7.88 |
13779 | General practice group medical visit - 19 patients | 0 | $7.60 |
13780 | General practice group medical visit - 20 patients | 0 | $7.41 |
13763 | General practice group medical visit - 3 patients | 0 | $25.95 |
13764 | General practice group medical visit - 4 patients | 0 | $20.95 |
13765 | General practice group medical visit - 5 patients | 0 | $18.01 |
13766 | General practice group medical visit - 6 patients | 0 | $16.03 |
13767 | General practice group medical visit - 7 patients | 0 | $14.62 |
13768 | General practice group medical visit - 8 patients | 0 | $13.57 |
13769 | General practice group medical visit - 9 patients | 0 | $12.71 |
13781 | General practice group medical visit- >20 patients | 0 | $7.14 |
14002 | General practice group medical visit- >20 patients | 0 | $50.00 |
Gynecology & Pregnancy |
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00118 | Caesarean section-attendance | 0 | $91.09 |
14109 | Delivery - attendance - emerg c/s | 0 | $490.12 |
14104 | Delivery and post-natal care (1-14 days in-hosp) | 0 | $588.41 |
14008 | Full service gp-bonus with post natal care | 0 | $77.23 |
14005 | Full service gp-bonus with transfer higher care | 0 | $156.34 |
14009 | Full service gp-obstet delivery bonus-w c section | 0 | $312.70 |
14004 | Full service gp-obstet delivery bonus-w delivery | 0 | $375.40 |
14540 | Insertion intrauterine contraceptive device | 2 | $43.28 |
14105 | Management of labour and transfer to higher level | 0 | $245.04 |
14010 | Maternity network incentive | 0 | $2,100.00 |
14545 | Medical abortion | 0 | $165.47 |
14199 | Mngmnt of prlngd 2nd stg labour - per 30 mins | 0 | $85.47 |
00119 | Newborn care, routine, in hospital | 0 | $93.11 |
14108 | Post-natal care after elective c-section | 0 | $121.06 |
14094 | Post-natal office visit | 0 | $31.81 |
15120 | Pregnancy test, immunologic, urine | 0 | $11.72 |
14091 | Prenatal visit - subsequent examination | 0 | $31.81 |
14090 | Prenatal visit- complete examination | 0 | $84.95 |
14560 | Routine pelvic exam including pap | 0 | $31.72 |
Laboratory Services |
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15132 | Candida culture (in physicians office) | 0 | $6.67 |
93120 | E.c.g. tracing, without interpretation (technical) | 0 | $16.97 |
30015 | Eosinophils - secretion smear | 0 | $7.29 |
15133 | Examination of eosinophils/secretions/excretions | 0 | $7.14 |
15136 | Fungus, direct examination, koh preparation | 0 | $8.39 |
15100 | Glucose - semiquantitative | 0 | $3.70 |
15137 | Haemoglobin - cyanmethaemoglobin | 0 | $3.12 |
15000 | Haemoglobin -other methods (in physicians office) | 0 | $1.62 |
00012 | Injection, venepuncture | 0 | $5.99 |
15110 | Occult blood - feces | 0 | $5.37 |
15134 | Pinworm ova-examination | 0 | $5.85 |
15138 | Sedimentation rate (in physicians office) | 0 | $2.51 |
15139 | Sperm, seminal examination for presence or absence | 0 | $14.78 |
15140 | Stained smear (in physicians office) | 0 | $7.40 |
15141 | Trichomonas and / or candida, direct examination | 0 | $5.69 |
15130 | Urinalysis - screening | 0 | $2.19 |
15131 | Urinalysis - micro exam of centrifuged deposit | 0 | $4.15 |
15142 | Urinalysis-complete diagnostic, semi-quant & micro | 0 | $5.65 |
15143 | White cell count only | 0 | $6.48 |
Mental Health Planning & Management |
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14044 | Gp mental health management fee age 2-49 | 0 | $56.76 |
14045 | Gp mental health management fee age 50-59 | 0 | $62.43 |
14046 | Gp mental health management fee age 60-69 | 0 | $65.26 |
14047 | Gp mental health management fee age 70-79 | 0 | $73.77 |
14048 | Gp mental health management fee age 80+ | 0 | $85.12 |
14043 | Gp mental health planning fee | 0 | $100.62 |
Minor Procedures |
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13623 | Excision tumour skin/subcututaneous/small scar | 0 | $90.04 |
14541 | Removal of intrauterine device (iud) | 0 | $31.72 |
13624 | Removal scars (5 cm or more) per cm over 5 c | 0 | $8.62 |
Other GPSC Fees |
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14086 | Gp assigned inpatient care network | 0 | $2,100.00 |
14088 | Gp unassigned inpatient care fee | 0 | $150.00 |
14063 | Palliative care planning fee-general practice | 0 | $100.62 |
14066 | Personal health risk assessment | 0 | $50.31 |
14067 | Personal health risk assessment | 0 | $18.22 |
Procedures |
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13621 | - additional lesions removed at the same sitting (maximum per sitting, five) each (operation only) | 0 | $33.39 |
13601 | Biopsy - facial area (operation only) | 2 | $52.24 |
13600 | Biopsy of skin or mucosa (operation only) | 2 | $52.24 |
00190 | Electrosurg./cryotherapy for removal of warts etc. | 0 | $31.72 |
13650 | Enucleation or excision of ext thrombotic haemorrh | 2 | $52.44 |
13620 | Excision of tumour of skin or subcutaneous tissue or small scar under local anesthetic - up to 5 cm (operation only) | 2 | $66.76 |
13612 | Extensive laceration greater than 5cm | 2 | $13.40 |
10710 | In-office anoscopy | 0 | $7.96 |
13622 | Localized carcinoma of skin proven histopath. | 2 | $73.75 |
13660 | Metatarsal bone - closed reduction | 2 | $53.11 |
13701 | Metatarsal bone - closed reduction | 0 | $50.00 |
13702 | Metatarsal bone - closed reduction | 0 | $40.00 |
13706 | Metatarsal bone - closed reduction | 0 | $20.12 |
13707 | Metatarsal bone - closed reduction | 0 | $7.04 |
13708 | Metatarsal bone - closed reduction | 0 | $43.23 |
13610 | Minor laceration or foreign body - no anaesthesia | 0 | $35.84 |
13611 | Minor laceration/foreign body requiring anaes. | 2 | $66.76 |
13631 | Nail removal - simple | 2 | $35.75 |
13632 | Nail removal with destruction of nail bed | 2 | $72.34 |
13605 | Opening superficial abscess, including furuncle - operation only | 2 | $44.76 |
13630 | Paronychia | 2 | $35.75 |
13633 | Wedge excision of one nail | 2 | $63.83 |
Surgical Assistant Or Second Operator |
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13052 | Anaes. evaluation - non-certified anaesthetist | 0 | $55.93 |
13194 | Gp first surgical assist of the day | 0 | $89.09 |
00193 | Non-cvt cert. surgical assist @ open heart surgery | 0 | $30.89 |
00196 | Surgical assist $317.01 to 529.00 inclusive | 0 | $189.24 |
00198 | Surgical assist time after 3 hrs - per 15 mins | 0 | $28.52 |
00195 | Surgical assist-less than $317.00 inclusive | 0 | $134.22 |
00197 | Surgical assistance - operations over $529.00 | 0 | $261.76 |
Telehealth |
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13338 | Community based gp,1st fac visit of day bonus,extr | 0 | $49.84 |
13236 | Telehealth GP Consultation (age 0-1) | 0 | $85.40 |
13436 | Telehealth GP Consultation (age 2-49) | 0 | $77.63 |
13536 | Telehealth GP Consultation (age 50-59) | 0 | $84.87 |
13636 | Telehealth GP Consultation (age 60-69) | 0 | $89.28 |
13736 | Telehealth GP Consultation (age 70-79) | 0 | $100.91 |
13836 | Telehealth GP Consultation (age 80+) | 0 | $116.11 |
13238 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 0-1) | 0 | $62.43 |
13438 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 2-49) | 0 | $56.76 |
13538 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 50-59) | 0 | $62.05 |
13638 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 60-69) | 0 | $65.26 |
13738 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 70-79) | 0 | $73.77 |
13838 | Telehealth GP Individual Counselling for a prolonged visit for counselling (age 80+) | 0 | $85.12 |
13237 | Telehealth GP Visit (age 0-1) | 0 | $34.90 |
13437 | Telehealth GP Visit (age 2-49) | 0 | $31.72 |
13537 | Telehealth GP Visit (age 50-59) | 0 | $31.72 |
13637 | Telehealth GP Visit (age 60-69) | 0 | $36.47 |
13737 | Telehealth GP Visit (age 70-79) | 0 | $41.22 |
13837 | Telehealth GP Visit (age 80+) | 0 | $47.59 |
Urology |
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13655 | General practice - vasectomy bonus | 0 | $21.57 |
The information presented on this page is 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. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.
MSP Billing Codes
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- Anaesthesia
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