Coronavirus: Alberta adds new billing codes for doctors providing virtual care

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The government of Alberta announced Monday it was adding new temporary physician billing codes so that doctors are compensated for providing virtual care during the COVID-19 pandemic.

Using the new health service codes, physicians will be paid the same rate as if the medical services were provided in person, the province said.

The change comes after Alberta family doctors voiced concerns with current billing methods and urged the province for more support of virtual options.

“These new virtual care codes will make it possible for physicians to deliver care safely and effectively to patients during the pandemic,” said Dr. Christine P. Molnar, president of the Alberta Medical Association.

“These codes apply not only for COVID-19 care, but for all the physical and mental health needs of patients as they present every day.

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“Delivering virtual care will maintain ongoing physician-patient relationships which are essential for quality care. These codes represent an important step towards ensuring the viability of physicians’ practices, and supporting the thousands of Albertans they employ.”

The new physician billing codes will apply to patient visits, consultations, and mental health services provided over the phone or through secure video conference. They will not be subject to the daily patient visit cap, the government said. The change is retroactive to March 17, a health bulletin explains.

Brendan Vaughan, a family physician in Calgary, said the billing changes are “immensely helpful and long overdue,” especially given the immediate COVID-19 health crisis.

“I’m happy that some changes are coming — that every other province, with the exception I believe of Nunavut and Quebec, have instigated … But I don’t think that this is meaningful signalling to the profession that this is a government that has our back.”

Vaughan said a few things that stand out as red flags for him are that services provided through virtual appointments must be initiated by the patient, that the Business Cost Program will not apply, and that neither will complex modifiers.

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“Premiums, including age modifiers, complex modifiers, after-hours time premium, Business Cost Program (BCP) and Rural Remote Northern Program (RRNP) will not apply to virtual HSCs,” the bulletin reads.

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Vaughan said he has many older patients — some returning home from warmer climates — who he would like to reach out to and advise them to self-isolate for 14 days to prevent any potential spread of COVID-19.

Vaughan believes the new billing codes will help doctors address the current health emergency but he doesn’t feel they indicate the Alberta government is willing to find common ground with family doctors in the longer-term.

“This is probably going to dial down the profession’s anger and allow us to focus on the task at hand… And help support our patients — which we will do and are doing — by keeping our practices open. But the messaging being sent in here is still very antagonistic.

“It clearly flags that this government intends to push through all planned April 1 framework changes other than complex modifier.”

However, Vaughan said he was very encouraged to see the supports for doctors offering mental health care to patients.

“Mental health counselling codes are extremely necessary right now. We are seeing heightened need in our most vulnerable patients.”

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Billing rates vary depending on physician type and the service provided and are the same as the current in-person rate, the government news release said.

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In-person medical care will continue, the province added, but virtual services will be offered by doctors and specialists “where appropriate.”

Dr. Heather Shonoski, a physician in Peace River, described the billing changes as “a good first step.”

She believes the option to see patients through methods other than face-to-face encounter will help flatten the curve, keep patients out of the emergency department and maintain continuity of care.

Shonoski said compensation for virtual visits will help sustain practices through this period of unprecedented hardship as medical professionals respond to the COVID-19 health crisis.

She and other rural doctors estimate that even with the new billing code, they’ll receive 10-50 per cent less compensation than they would for an in-person visit, depending on the complexity of the case and how rurally they are located.

“Hopefully, our family medicine practices will continue to exist and serve our patients after this pandemic ends,” Shonoski said.

Her biggest concern with the changes is that patients must initiate the virtual appointment. Shonoski said her most at-risk patients won’t necessarily identify as vulnerable and they may fall through the cracks. Many won’t know about these changes or request a virtual appointment.

“They don’t know to ask,” she said.

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“We’re helping physicians provide care to Albertans during this critical time while also keeping them as safe as possible,” the health minister said.

“Virtual care codes will facilitate patient care while making it possible to follow public health guidelines of maintaining social distance and self-isolation,” Tyler Shandro said in a news release.

“Physicians should choose the best way to provide the care Albertans deserve without having to worry about fair compensation for their services.”

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