Updated: April 27th, 2020
The Specialist Services Committee (SSC) has introduced 4 new time-limited fee codes.
New Fee Codes related to COVID-19
- 10007 Specialist Email/Text/Telephone Medical Advice Relay or reRX Fee (effective March 27th)
- 10008 Urgent Specialist COVID-19 Advice (effective March 27th)
- 10000 Urgent Specialist Advice on patient with previous visit/service Fee (similar to 10001 – effective April 15th)
- 10009 Non-urgent Specialist Advice on patient with previous visit/service Fee (similar to 10002 – effective April 15th)
10007 and 10008 Highlights
- Prescription renewal billable without patient interaction under the 10007 email/text/telephone advice relay or ReRX fee.
- Increase in the number of services allowable per patient per day under 10008.
- Increased opportunity to delegate some virtual care with 10007.
10000 and 10009 Highlights
- 10000 Urgent Specialist Advice allows advice to be provided regarding any patient, including those that may have had a paid visit/service for the same condition by the same practitioner in the previous 180 days.
- 10009 Non-Urgent Specialist Advice allows advice to be provided regarding any patient, including those that may have had a paid visit/service for the same condition by the same practitioner in the previous 30 days.
10007 Specialist Email/Text/Telephone Medical Advice Relay or reRX. Fee $10.10
10007 has some similarities to 10003 (Specialist Patient Management ) and 10006 (Specialist Email Patient Management) but allows for delegation to any Allied Health Care Provider or an MOA. The fee can also be billed for Prescription Renewal without patient interaction.
Guidelines:
- Email/Text/Telephone Relay Medical Advice requires two-way relay/communication of medical advice between yourself and the eligible patients, or the patient’s medical representative, via email/text or telephone. However, the task of relaying the physician advice may be delegated to any Allied Care Provider or MOA working within the physician practice.
- Chart entry must record the name of the person who communicated with the patient or patient’s medical representative, as well as the advice provided, modality of communication and confirmation the advice has been received.
- Payable for prescription renewals without patient interaction.
- Not payable for notification of appointments or referrals.
- Limit of one service payable per patient per day.
- Not payable on the same calendar day as a visit or service fee for the same patient.
- Not payable if you’re working under salary, service contract or sessional arrangements (as your duties would already include this care).
10008 Urgent Specialist COVID-19 Advice. Fee $60.00
10008 is similar to the existing Urgent Specialist Advice fee – 10001, except it’s specifically for COVID-19. If you’re providing advice about a patient regarding COVID-19, use 10008 not 10001. Instead of being limited to one claim per patient per day (like 10001), 10008 increases this limit to two.
Guidelines:
- Payable for telephone, video technology or face to face communication only about a patient regarding COVID-19. Not payable for written communication (i.e. fax, letter, email).
- Document time of initiating request, time of response, as well as advice given and to whom.
- Include the referring physician on your claim to indicate who requested the advice.
- Not payable in addition to another service on the same day for the same patient.
- Limited to two claims per patient per day.
- Not payable in addition to 10001 on the same day for the same patient.
10000 Urgent Specialist Advice on patient with previous visit/service. Fee $60.00
(Initiated by a Specialist, General Practitioner or Health Care Practitioner. Verbal, real-time response within 2 hours of the initiating physician’s or practitioner’s request).
Guidelines:
- Payable for telephone, video technology or face to face communication only about a patient. Not payable for written communication (i.e. fax, letter, email).
- Document time of initiating request, time of response, as well as advice given and to whom.
- Include the referring physician on your claim to indicate who requested the advice.
- Not payable in addition to another service on the same day for the same patient.
- Limited to one claim per patient per day.
10009 Specialist Advice for Patient Management on patient with previous visit/service. Fee $40.00
( Initiated by a Specialist, General Practitioner, Allied Care Provider, or coordinator of the patient’s care. Verbal real-time response within 7 days of initiating request).
Guidelines:
- Payable for telephone, video technology or face to face communication only. Not payable for written communication (i.e. fax, letter,
email). - Document time of initiating request, time of response, as well as advice given and to whom.
- Include the referring physician on your claim to indicate who requested the advice.
- Not payable in addition to another service on the same day for the same patient.
- Limited to one claim per patient per day and and two services per patient per week.
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. Otherwise, please check back to the COVID-19 Resource centre for more updates.
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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