April 1, 2000, and paid prior to July 1, 2000, will be made at a later date to be determined. Information will be provided in a subsequent communication.
The claims processing system will be programmed to pay the new fee in lieu of a lesser fee claimed for a transitional period to allow physicians time to update billing systems.
2. New or Amended Fee Codes
The following new fees or amended fees are being introduced effective July 1, 2000.
K070 Home Care Application $16.50
The new Home Care Application fee is payable to the most responsible physician for personal completion and submission of a home care service request form to the Community Care Access Centre (CCAC) on behalf of a patient for whom the physician provides on-going medical care. The fee is payable when the form is submitted to CCAC. If the form is completed in whole or in part by a person other than the physician or the physician's employee, the fee payable is zero. This fee is payable to general practitioners and specialists in addition to the appropriate assessment fee.
K071 Acute Home Care Supervision $10.40
K072 Chronic Home Care Supervision $10.40
The new Acute Home Care Supervision and Chronic Home Care Supervision fees are payable to the most responsible physician who personally provides advice, direction or information in response to an inquiry from CCAC staff or CCAC contracted staff on behalf of a patient for whom the physician provides on-going medical care. The date, question, response and identity of the health care staff must be recorded in the patient's health care record. This fee is payable to both general practitioners and specialists.
Acute Home Care Supervision, K071, is payable to a maximum of one per patient every two weeks for the first 12 weeks following admission to the home care program. Chronic Home Care Supervision, K072, is payable to a maximum of one per patient per month commencing the thirteenth week following admission to the home care program.
The amount payable for home care supervision in excess of the maximums, without the required record of service in the patient's medical record, or with a consultation or visit for the same patient on the same day by the same physician, is zero.
E075 Geriatric General Assessment Premium
A new 20% premium for geriatric general assessment is payable to the most responsible physician in addition to a general assessment. It is payable once per 12-month period for a patient aged 75 years or older and for whom the physician provides on-going primary care. The amount payable for additional geriatric general assessment premiums claimed by any physician for the same patient in the same 12-month period are payable at zero. This fee is payable to general practitioners only.
E411 Sole Delivery Premium
This new 50% premium is payable in addition to labour and delivery services, P006A, P009A, P018A, P020A or P038A, when the physician performs only one delivery in a calendar day. This premium is payable to a maximum of 25 sole delivery premium services per physician, per 12-month period. It is not payable to assistants or anesthetists.
|Ontario Ministry of Health and Long-Term Care
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