Newsletter no023

Here are the latest changes announced in the infolettre n^o023 by the RAMQ regarding generalist practitioners.

Here are the topics involved:

• COVID-related coordination / organization duties;
• COVID-19 vaccination;
• Uncapping the clinical intervention.

Please note that we only share with you the most important details from these changes, and that a thorough reading of all published infolettres is necessary to your understanding.

COVID – RELATED COORDINATION / ORGANIZATION DUTIES

Upheld billing terms

Access to the following billing terms is no longer suspended:

• (GMF or GMF-R head physician only) Activity code 72101 with sector 47 that allows for the billing of COVID-related coordination duties without any limitation of hours;
• (GMF or GMF-R physician – not head of department) Billing code 19017#DC19, that allows a physician who is not the head of department to be compensated for their participation to COVID-related duties;
• (On-call physician nominated by the joint committee as a medical responder) Billing codes 42185 and 42186.

Retroactively as of January 15, 2021, you have 120 days starting on April 21 to invoice your services.

Physician appointed to the Comité de priorisation pour l’accès aux soins intensifs adultes

Here are the terms available:

• Hourly rate of 186,15$ (code 19729 : minutes : start-end) billable using the ICU sector (intensive care unit);
• Daily on-call duty fee of 82,40$ per 8-hour period, divisible in 60-minute periods (code 19730 : minutes : start-end);
• Weeknight/weekend/holiday supplement, billable Monday to Friday from 18h to 24h and at all time on Saturday, Sunday or a holiday (code 19683).

The DSP or the head of the département clinique de médecine générale must send the list of physicians involved to the joint committee, who then sends it to the RAMQ. The list serves as the nomination required to access those billing terms.

For more information on the terms above, click here.

Retroactively as of January 1st, 2021, you have 120 days starting on April 21 to invoice your services.

Physician acting as co-head of department for the medical services in a CHSLD

With a nomination from the DSP or head of department, you may use the activity codes from paragraph 4,01 :

• TH 49259 Coordination – COVID-19
• TH 49260 Expertise professionnel – COVID-19

Retroactively as of January 1^st, 2021, you have 120 days starting on April 21 to invoices your services.

Physician appointd to the mécanisme de coordination gériatrique nationale ou régionale

If you act as coordinator for the mécanisme de coordination médicale gériatrique nationale ou régionale (CMG-n or CMG-r), you may claim the following billing terms between 8h and 22h using one of the two options. These terms can be billed only at a facility type CSSS, CISSS or CIUSSS (9XXXX).

Example with option 1 :

Physician on-call from 16h to 24h during the week, who did two 45-minute phone consults during the day:

Line 1 -> Code 19731:480:1600-2400

Line 2 -> Code 19732:45:1615-1700

Line 3 -> Code 19732:45:2030-2115

Line 4 -> Code 19683:360:1800-2400

Outside of those consults, the physician claims their services using their usual remuneration mode.

Example with option 2 :

Physician on-call from 16h to 24h during the week, who did six 30-minute phone consults during the day:

Line 1 -> Code 19734:0800-1700

Line 2 -> Code 19732:30:0915-0945

Line 3 -> Code 19732:30:1030-1100

Line 4 -> Code 19732:30:1300-1330

Line 5 -> Code 19732:30:1345-1415

Line 6 -> Code 19732:30:1445-1515

Line 7 -> Code 19732:30:1600-1630

Outside of those consults, no other service can be claimed.

Retroactively as of January 1^st, 2021, you have 120 days starting on April 21 to invoice your services.

COVID-19 VACCINATION

Physician in charge 

Whenever you are on site and act as the physician in charge of a mass vaccination operation, you may claim the billing terms from the LE 269 using the modifier #RVAC médecin responsable clinique dans le cadre d’une séance de vaccination de masse contre la COVID.

The option is between either the rate from the LE 269 or the usual remuneration mode. If your usual mode is hourly rate mode or fixed rate mode, the activity code XXX261 with the usual service nature code must be used. (Use the same code as usual and change the last 3 digits to 261)

Non-traditional vaccination site

To bill at one of those types of facility, 2 options are possible:

• Codes for vaccination (20023 and 20024) using modifier #VAC séance de vaccination contre la COVID-19; OR
• Hourly rate (42230). Example : 42230:min:start-end of the shift.

Please consult the list of designated non-traditional sites that will soon be published in the annexes

COVID-19 vaccination in a CHSLD

If the vaccination is done in a CHSLD, you may claim the billing terms of the LE 269, using modifier #VAC séance de vaccination contre la COVID-19, even if the facility is not part of the LE 269 designated facilities.

Retroactively as of December 14, 2020, you have 120 days starting on April 21 to invoice your services.

CLINICAL INTERVENTION

During the health emergency, the daily cap of 180 minutes, at all facilities for all patients, is suspended. There is no limit of billable minutes.