Skip to content

Ensuring physicians are appropriately compensated during your response to COVID-19 is a top priority for MSPEI.

New Billing Rules

Note: As the landscape of authorized codes and billing requirements are changing daily.  In the interests of ensuring physicians are compensated for the work they are doing during this trying time, and recognizing that work is carrying-on while we continue to work with Government and Health PEI to get the necessary agreements in place, MSPEI is recommending you continue to track the various ways in which you are providing care (even if it is not reflected in the current tariff or has not yet been approved).  This information may be needed to support future compensation discussions and for retroactive compensation, where appropriate.

The following new billing rules have been introduced to accommodate COVID-19:
(Last Updated: April 7, 2020)

Virtual Care

Effective March 16, 2020, physicians will be eligible to bill for following fee codes for services delivered via virtual care (telephone, secure videoconferencing, and secure email/text) during the COVID-19 pandemic:

  • Limited Office Visit – fee code xx13 (including at a walk-in clinic)
  • Health Promotion Counseling – fee code 2505
  • Psychotherapy – fee code 2501 or 2504
  • Diagnostic and Therapeutic Interview – fee code 2588, 2586, 2886
  • Consultation – fee code xx60
  • Repeat consultation – fee code xx62
  • Geriatric follow up visit – fee code 2863
  • Postnatal visit – fee code 0705
  • FOR SPECIALIST USE ONLY: Comprehensive Office Visit – fee code xx10 for patients who have been initially referred for consultation and a subsequent visit relates to the same diagnosis.

All patient interaction needs to be documented and appended to the patient chart.

Billing Instructions:

  • Service must be direct patient care by a physician to a patient, in lieu of a face-to-face visit.
  • Service can be initiated by either the physician or the patient.
  • These services are only billable for medically necessary services that can be safely and competently delivered via virtual care.
  • Physical examination not required when completed by virtual care for fee code xx13.
  • Postnatal visit will not require pelvic exam when completed by virtual care. Pelvic exam can be delayed until non-pandemic times.
  • For time-based codes (2501, 2504, 2505, 2586, 2588, 2886) please make sure the time of day is on the claim. Also these codes are a minimum of 15 minutes.
  • Patient chart must document that it was a telemedicine (telephone, secure email/text, and secure videoconferencing) in lieu of physical visit for COVID-19.
  • Physicians must continue to document in patient chart as per Tariff of Fees Preamble requirements.
  • For patients in self-isolation, the billing claim must include “COVID-19 self-isolation”.
  • For all other patient care delivered via telephone, the billing claim must include a comment “COVID-19 telemedicine”

Billing Memo & Virtual Codes_April 16 – April 16 (most updated)

Physician Billing FAQs  – March 31

Administrative Work

Physicians participating in COVID-19 planning meetings, organized by Health PEI, are eligible to bill fee code 0050 Administrative Meetings. In the billing claim, please include in the comment “COVID-19 meeting”. Given the unique situation, temporary billing measures allow billings for one staff meeting per week.  This will be reviewed in mid-April and, as above, we encourage you to track all time spent in administrative meetings for future reflection.

Income Protection while ill or in self-isolation

Salary Physicians
Health PEI will provide physicians with the paid leave, while they self-isolate according to Public Health Office guidelines.  In addition, sick leave policies will support you should you become ill. Salary and contract physicians are asked to continue to submit their hours in the ordinary course and they will be compensated as per their contract.
See Employee COVID-19 FAQ – March 23

Fee-for-Service Physicians
Base Financial Compensation package is available to support fee-for-service physicians whose income has been or will be impacted by either the need to self-isolate or the move to essential services. It is in recognition that they are independent medical service providers and required to pay overhead expenses to keep their practices open.

For details contact tamzin@mspei.org.

Ongoing MSPEI Advocacy Work

We know you are focused on being where your patients and the health-care system needs you most.  While you do that, MSPEI is working with government and Health PEI to:

  • Expand virtual care codes to be reflective of how you are practicing today (i.e. increase available specialist codes, allow allied health to continue to provide appropriate delegated functions virtually, allow physician-to-physician consults anticipating the need for collaborative approaches to patient care)
  • Extend the provision of virtual care through non-approved technologies (Facetime, Jabber, etc., as  other provinces have done)
  • Determine how we can support you in using virtual care as part of your everyday practice (i.e. securing new platforms and tutorials on how to use).
  • Introduce new codes that may be specific to COVID care and response
  • Introduce an “income stability” program that provides you sound of mind that your compensation is not at risk while you adjust your practice to be where you are needed when your patients and the health-care system needs you. This program is also intended to support you through the potential need to self-isolate or if you become ill.
  • Bring cross-country learnings to PEI based on weekly briefings with the Canadian Medical Association and other provincial medical associations.

FAQs

View All FAQs

At this time, physicians should continue to shadow bill as they normally do.

Health PEI will be looking at what modifications to the blended payment thresholds for January to March 2020 will be needed, given these unprecedented times in responding to this pandemic.

Effective March 16, 2020, physicians will be eligible to bill for following fee codes for services delivered via telephone during the COVID-19 pandemic:

  • Limited Office Visit – fee code xx13
  • Health Promotion Counseling – fee code 2505
  • Psychotherapy – fee code 2501 or 2504
  • Diagnostic and Therapeutic Interview – fee code 2588 or 2586

Billing Instructions:

  • Service must be direct patient care by a physician to a patient, in lieu of a face-to-face visit.
  • Service can be initiated by either the physician or the patient.
  • These services are only billable for medically necessary services that can be safely and competently delivered via telephone.
  • Physical examination not required when completed by telephone for fee code xx13.
  • For time based codes (2501, 2505, 2586, and 2588) please make sure the time of day is on the claim. Also these codes are a minimum of 15 minutes.
  • Patient chart must document that it was a telephone call in lieu of physical visit for COVID-19.
  • Physicians must continue to document in patient chart as per Tariff of Fees Preamble requirements.
  • For patients in self-isolation, the billing claim must include “COVID-19 self-isolation”.
  • For all other patient care delivered via telephone, the billing claim must include a comment “COVID-19 telemedicine”

Please note that this is a temporary measure and will be reviewed again in 30 days.

Yes, the codes listed above in Question #2 will apply for secure videoconferencing. The codes will also apply to email correspondence with patients through secure email platforms only such as Groupwise.

Please be advised that Gmail, Yahoo mail, etc is not considered secure email, and that FaceTime is not considered secure videoconferencing at this time.

No, physicians cannot bill for a telephone prescription renewal on the same day that they bill virtually for a Limited Office Visit – fee code xx13; Health Promotion Counseling – fee code 2505; Psychotherapy – fee code 2501 or 2504; or Diagnostic and Therapeutic Interview – fee code 2588 or 2586.

However, Health PEI will temporarily suspend the restriction to bill telephone prescription renewal on Day 2 and Day 3 after a visit code is billed.

You can certainly answer questions from patients and bill for these questions and advice provided they are medically necessary. Please make sure a copy of the patient email and advice provided are in the patient’s chart.

Yes, telephone calls will be permitted to patients who cannot attend a walk in clinic in person due to COVID-19. As a temporary measure, the physician should bill fee code 0113 Limited Office visit, and a comment must be added to the billing claim. For patients in self-isolation, include “COVID-19 self-isolation” and for all other patient care delivered via telephone include “COVID-19 telemedicine”.

For those physicians who are participating in COVID-19 planning meetings organized by Health PEI as part of our pandemic planning, you are eligible to bill fee code 0050 Administrative Meetings for time spent in these meetings. In the billing claim, please include in the comment “COVID-19 meeting”.

Given the unique situation that we find ourselves in with COVID-19, and as part of our temporary billing measures, we will temporarily allow billings for one staff meeting per week. This will also be reviewed again in mid April.

Health PEI recognizes that individuals who are fee for services are independent and are impacted when essential services are in place and/or when patients cancel appointments since they cannot bill for services that were not rendered.

To that end, Health PEI is working with Government officials to provide financial support to those significantly impacted by the move to essential services. Conversations are currently underway to identify what these supports may be.

More information will be forthcoming on this as developments arise, but please be assured that we are committed to getting a solution in place as soon as possible.

Health PEI foresees that the financial support as outlined in Question #9 would also apply to locum physicians. More information will be forthcoming on this as solutions are developed.

Salaried Physicians

If you are a salaried physician, who is asymptomatic (not experiencing symptoms) be required to self-isolate, you will be placed on paid administrative leave. If you have the option/ability to do some virtual care from home, please discuss this with your Medical Director.

Should a salaried physician develop any symptoms of COVID-19, such as fatigue, aches, fever, cough and difficulty breathing, you should call 811 for screening to determine whether a test is appropriate.

Once symptomatic, paid administrative leave ends and standard sick leave begins as outlined in the respective collective agreement.

If a salaried physician tests positive for COVID-19, you will be required to continue to self- isolate and follow medical advice. This may extend past the 14 day self-isolation period.

Contract for Services Physicians

If you are a contract for services physician, and you were scheduled to work during your timeframe in isolation, please continue to submit your regularly scheduled hours on your timesheet and submit to Medicare. If you are able to work virtually from home, you are encouraged to do so. include the comment “Physician Self Isolation”.

Sessional Physicians

If you are a sessional physician, and you were scheduled to work during your timeframe in isolation, please continue to bill your sessional rates for the hours/days that you were scheduled to work, and include the comment “Physician Self Isolation” on your billing claim.

Fee-For-Service Physicians

If you are a fee-for-service physician, it is anticipated that this will fall under the financial support that we are hoping to develop as outlined in Question #9. More information will be forthcoming on this as solutions are developed.

Please note:

Physicians who choose to travel outside of Canada following the March 13, 2020, travel restriction recommendations and the 14 day required self-isolation notification are not eligible for paid leave during the 14 day self-isolation period.

It is important to notify your Medical Director as to changes in your status regardless of your payment modality.

The date the new Master Agreement will be implemented will be determined through discussions with the Medical Society of PEI. The effective date of any new fee codes or changes will be honored if implementation does not occur until after their effective date.

Thank you for your cooperation in being re-deployed where you are needed most. At this time, please contact your medical director/program medical director/department head to discuss this option.

Here is a listing of current medical directors/program medical directors/department heads:

Acute Care Medical Directors
QEH Dr Hussam Azzam
PCH Dr Wassim Salamoun
Network Medical Directors
West Dr Wassim Salamoun
Queen Dr Ed White
Kings Dr Laura Neumann
Program Medical Directors
Chief Medical Information Officer Dr Spencer Brown
Diabetes Dr Lenley Adams
Diagnostic Imaging Dr Melanie McQuaid
Geriatrics Dr Martha Carmichael
Laboratory Services Dr Marvin Tesh
(acting for Dr Kristen Mead)
Long Term Care Dr Jan Rogerson
Medical Education Dr Shannon Curtis
Palliative Care Dr Mireille Lecours
(Dr. Janet Baker acting until March 23)
Physical Medicine Dr Edmund Harrison
Department Heads- Queen Elizabeth Hospital
Anaesthesia Dr Jean-Yves Dubois
Cardio-Respiratory Dr Ayodeji Harris-Eze
Emergency Medicine Dr Ron Whalen
Family Medicine Dr Laura O’Connor
(acting for Dr Andrew Wohlgemut)
Hospitalist Dr Jill Cunniffe
Dr Lori Cheverie
ICU/CCU Dr Patrick McCrea
Internal Medicine Dr Lenley Adams
Oncology Dr Philip Champion
OBGYN Dr Shaun Ferguson
Pediatrics Dr Peggy Bethune
Surgery Dr Kristian MacDonald
Department Heads – Prince County Hospital
Anaesthesia Dr Brenda Keeping
Emergency Medicine Dr Ryan Lieph
Family Medicine Dr John Morash
Internal Medicine Dr Michael Irvine
OBGYN Dr Hani Farag
Pediatrics Dr April MacPhee
Surgery Dr David Bannon

General Questions

Gail Scott
Director, Medical Affairs
Email: gascott@ihis.org
Phone: 902-368-3692

Billing Questions

Lauren Kelly Weyman
Manager, Physician Services – FM
Email: lekelly@ihis.org
Phone: 902-368-6736

Locum Questions

Nadine MacLean
Manager, Physician Services – Specialists
Email : nmmaclean@gov.pe.ca
Phone : 902-368-6147

Load More

FREQUENTLY ASKED COMPENSATION QUESTIONS
(Prepared by Health PEI, Medical Affairs –  March 19th, 3 p.m)