MSP Billing Codes

Specialty: Msp Billing Codes By Specialty

Category: Family Medicine

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Code	Description	Anes	Fee
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Chronic Disease Management Incentives
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
13655	General practice - vasectomy bonus	0	$21.57

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