Billing Information for a RACE call

UPDATED SPECIALIST SERVICES COMMITTEE FEES:Updated SSC Fees Nov 1, 2015.pdf

Billing Information for a RACE call

  • Billing code G10001 – $60.00 – for calls returned within 2 hours
  • Billing code G10002 – $40.00/15 minute interval – for calls from a nurse practitioner

Billing code G10001 – $60.00 – for calls returned within 2 hours

*As of Nov 1, 2015 – Expand fee to include real-time face to face and video communication to better reflect the way that specialists communicate. See link above for more information.

 

 

Initiated by another Specialist or General Practitioner, this fee is to be used when immediate advice is required. Specialists can bill this item when they provide telephone advice to the initiating physician within two hours. Notes: Payable to Specialist Physicians for two-way telephone communication (including other forms of electronic verbal communication) regarding assessment and management of a patient but without the consulting physician seeing the patient.

  • Conversation must take place within two hours of the initiating physician’s request. Not payable for written communication (i.e. fax, letter, e-mail).
  • Includes discussion of pertinent family/patient history, history of presenting complaint, and discussion of the patient’s condition and management after reviewing laboratory and other data where indicated.
  • A chart entry, including advice given and to whom, is required.
  • If a call is from Out of Province it follows ALL the rules of Reciprocal Billing. That means the patient’s full contact info has to be included along with the Provincial Billing Number. i.e. full address.

Not payable for situations where the purpose of the call is to:

  • book an appointment
  • arrange for transfer of care that occurs within 24 hours
  • arrange for an expedited consultation or procedure within 24 hours
  • arrange for laboratory or diagnostic investigations
  • inform the referring physician of results of diagnostic investigations
  • arrange a hospital bed for the patient
  • Limited to one claim per patient per physician per day.
  • Out-of-Office Hours Premiums and Rural Retention Premiums may not be claimed in addition.
  • Not payable to physician initiating call.
  • Not payable in addition to another service on the same day for the same patient by same practitioner.
  • No claim may be made where communication is with a proxy for either physician (e.g. nurse or assistant).
  • Cannot be billed simultaneously with salary, sessional, or service contract arrangements.

Billing code G10002 – $40.00/15 minute interval – for calls from a nurse practitioner

*As of Nov 1, 2015 – Expand fee to include real-time face to face and video communication to better reflect the way that specialists communicate. See link above for more information.

 

 

Initiated by another Specialist, General Practitioner or Allied Care Provider, this fee is to be used when a referring provider needs advice and guidance with the management of a patient. Specialists can bill this item when they provide telephone advice to the initiating provider within one week. Notes: Payable to Specialist Physicians for two-way telephone communication (including other forms of electronic verbal communication) regarding assessment and management of a patient but without the consulting physician seeing the patient.

  • Conversation must take place within 7 days of initiating physician or allied care provider’s request. Initiation may be by phone or referral letter.
  • If conversation is with an allied care provider, include a note record specifying the type of provider.
  • Includes discussion of pertinent family/patient history, history of presenting complaint, and discussion of the patient’s condition and management after reviewing laboratory and other data where indicated.
  • A chart entry, including advice given and to whom, is required.
  • Include start and end times in the patient’s chart and time fields when submitting claim.

Not payable for situations where the purpose of the call is to:

  • book an appointment
  • arrange for transfer of care that occurs within 24 hours
  • arrange for an expedited consultation or procedure within 24 hours
  • arrange for laboratory or diagnostic investigations
  • inform the referring physician of results of diagnostic investigations
  • arrange a hospital bed for the patient
  • Limited to two services per patient per physician per week.
  • Out-of-Office Hours Premiums and Rural Retention Premiums may not be claimed in addition.
  • Not payable to physician initiating call.
  • Not payable in addition to another service on the same day for the same patient by same practitioner.
  • No claim may be made where communication is with a proxy for the consultant physician (e.g. nurse or assistant).
  • Cannot be billed simultaneously with salary, sessional, or service contract arrangements.

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