Telephone Fees - Frequently Asked Questions
- A General Practitioner called a Specialist directly to ask if the Specialist could see a patient for an urgent consultation, can the Specialist bill fee items G10001 or G10002?
No, the telephone fees are not billable for arranging an expedited consultation or procedures within 24 hrs.
- Cardiologist A is going on vacation and called Cardiologist B to arrange for the transfer of a patient’s care, are fee items G10001 or G10002 billable?
No, the telephone fees are not billable when the sole purpose of the call is to arrange for transfer of care.
- A Specialist called a patient’s family physician for additional information in order to render a consultation on the patient, can the Specialist bill fee items G10001 or
No, the telephone fees are not billable by the physician initiating the call.
- Paediatrician called a Nephrologist to discuss a patient’s medical condition and asked for advice on how best to treat the patient, can the Nephrologist bill fee items
G10001 or G10002?
Yes, the telephone fees are billable for clinical discussion and advice provided, including discussion of the pertinent patient/family history and presenting complaint. If the response is within 2 hrs, bill fee item G10001, if the response is within 1 week, bill fee item G10002.
- A social worker called a Psychiatrist for advice on how to manage a disabled child
with exacerbated mental behaviour, can the Psychiatrist bill fee item G10001?
No, fee item G10001 is not applicable as this fee is intended for telephone communication between physicians who are registered with the Medical Services Plan. However; fee item G10002 may be billed as the call is initiated by an Allied Care Provider for patient management. * A note record specifying the type of provider and the start and end time must be included in your claim submission of fee item G10002.
G10003 - Specialist Telephone Patient Management/Follow-up–per 15 minutes or portion thereof
- This fee applies to two-way direct telephone communication (including other forms of electronic verbal communication) between the Specialist Physician and patient, or a patient’s representative. Not payable for written communication (e.g. fax, letter, e-mail).
- This fee is only payable for scheduled telephone appointments with the patient.
- Access to this fee is restricted to patients having received a prior consultation office visit, hospital visit, diagnostic procedure or surgical procedure from the same physician, within the 18 months preceding this service.
- Not payable in addition to another service on the same day, for the same patient by the same practitioner.
- Telephone management requires two-way communication between the patient and physician on a clinical level; the fee is not billable for administrative tasks such as appointment notification.
- No claim may be made where communication is with a proxy for the physician (e.g. nurse or assistant).
- This fee requires chart entry as well as ensuring that the patient understands and acknowledges the information provided.
- Include start and end times in the patient’s chart and time fields when submitting claims.
- Cannot be billed simultaneously with salary, sessional, or service contract arrangements.
- Out-of –Office Hours Premiums and Rural Retention Premiums may not be claimed in addition.
Access to this fee is restricted to patients having received a prior consultation, office visit, hospital visit, diagnostic or surgical procedure from the same physician within 18 months preceding fee item G10003. Since the only fee billed is 00632 within the preceding 18 months of the telephone follow-up fee, fee item G10003 is not applicable.
Fee item G10003 is to substitute for a scheduled in-office follow-up visit when medically required. It is not intended to be used to follow-up with every patient, only those who would previously have needed to return to your office. The same policies which apply to in-office visits would also apply to telephone follow-ups.
No, telephone communication must be provided by the Specialist Physician and cannot be delegated.
Refer to the Telephone Fees Information
Refer to the Telephone Fees Billing Tips