Billing Information for a RACE call

UPDATED SSC FEE GUIDE

Billing Information for a RACE call

  • Billing code G10001 Urgent Specialist Advice – initiated by a Specialist, General Practitioner or Health Care Practitioner, Response within 2 hours – $60.00
  • Billing code G14021 GP with Specialty Training Telephone Advice – Initiated by a Specialist, General Practitioner, or Allied Care Provider. Response within 2 hours – $60.00

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

Initiated by another Specialist, General Practitioner or Health Care Practitioner, this fee is to be used when immediate advice is required. The purpose of this fee is for the specialist to provide urgent real-time advice when the intent of communication is to replace the need for the specialist to see the patient in person. The consulting specialist is responsible for ensuring that an appropriate communication modality is used to meet the medical needs of the patient. Specialists can bill this item when they provide telephone advice to the initiating physician within two hours of initiating request.

Notes:

  • Payable to Specialist Physicians for urgent real-time advice (including telephone, video technology or face to face 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.
  • An adequate medical record/chart entry, including time of initiating request and time of response as well as advice given and to who, is required.
  • Include the practitioner number of the physician or health care practitioner requesting advice in the “referred by” field when submitting claim.
  • Limited to one claim per patient per physician per day.
  • Not payable to physician initiating communication.
  • Not payable in addition to another service on the same day for the same patient by same practitioner.
  • The specialist is responsible for the confidentiality and security of all records and transmissions related to video technology.
  • Not payable if there is a paid visit/service for the same condition by the same practitioner in the previous 180 days.

Billing code G14021 – $60.00 – GP with Specialty Training Telephone Advice – Initiated by a Specialist, General Practitioner, or Allied Care Provider, Response within 2 hours

Notes:

  • Payable to a GP with specialty training 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 provider’s request. Not payable for written communication (i.e. fax, letter, email).
  • 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.

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
  • convey the results of diagnostic investigations
  • arrange a hospital bed for the patient
  • Not payable to provider initiating call.
  • No claim may be made where communication is with a proxy for either provider (e.g.: office support staff).
  • Limited to one claim per patient per physician per day.
  • A chart entry, including advice given and to whom, is required.
  • Start and end times must be included with the claim and documented in the patient chart.
  • Not payable in addition to another service on the same day for the same patient by same physician.
  • Out-of-Office Hours Premiums may not be claimed in addition.
  • Cannot be billed simultaneously with salary, sessional, or service contract
    arrangements.
  • Include the practitioner number of the provider requesting advice in the “referred
    by” field when submitting claim. (For allied care providers not registered with MSP
    use practitioner number 99987).

Still have Questions?

Link to SSC Frequently Asked Questions

If you are unsure about how to bill the fees, you can receive trusted advice from Doctors of BC’s Lea Harth, Fee Guide Assistant lharth@doctorsofbc.ca or call 604-638-2827 or MSP/HIBC Provider Programs 604-456-6950 (Vancouver) or 886-456-6950 (rest of the province).