Fee Code Program

Enhancements to the fee for-service schedule, through FPRP’s Fee Code Program, are intended to achieve patient, physician, and health system benefits such as comprehensive care, collaboration with other providers, and improvements in patient access. Participation in the fee code program is subject to eligibility requirements and requires a one-time online registration. There are now 250+ family physicians registered to access the following FPRP codes:

  • Code 520 – a Shared Care Code, which provides participating physicians with compensation for two-way collaborative conferencing with other health care providers for development of a patient care plan;
  • Code 521 – a Patient Care Telephone Code, which provides participating physicians with compensation for two-way telephone communication between the physician (or other health care provider employed within the physician’s office) and the patient (or the patient’s medical representative); and 
  • Code 522 – a Code for Enhanced Care of Patients with Chronic Obstructive Pulmonary Disease (COPD). 

 

Resources: Guides & FAQs

Telephone Code (521)
Shared Care Code (520)
All Codes
Webinar

Registration and Eligibility Criteria FAQs

FAQs

  • A new fee code is now available to fee-for-service family physicians for enhanced care of patients with Chronic Obstructive Pulmonary Disease (COPD). The new code (522) is an add-on to an office or hospital outpatient partial assessment or to a chronic disease management visit. This code is also payable as an add-on to the following visits which occur in a home or DHCS long term care facility: 210, 246a, 252, 285, 286a, 292. This code is payable to the family physician who is most responsible for the majority of the patient’s longitudinal care. Fee code 522 can be billed to a maximum of two billings per patient for a maximum of eighty patients per physician per billing year. To learn more about the COPD code, please read the announcement.
  • Provides participating physicians with compensation for two-way telephone communication between the physician (or other health care provider employed within the physician’s office) and the patient (or the patient’s medical representative).
  • Payable at $10 per 5 minutes (i.e. one unit).
  • Calls are payable for 4 units per patient per day and to a maximum of 225 units per physician annually. Note: Annual maximum of 225 units was temporarily lifted during COVID-19 pandemic and was reinstated effective October 15, 2020.
  • Not payable for simple prescription renewals, notification of normal test results, or notification of office, referral, or other appointments.
  • Provides participating physicians with compensation for two-way collaborative conferencing with other healthcare providers for development of a patient care plan.
  • If the patient is present, payable at $30 per 15 minutes (i.e. one unit).
  • If the patient is not present, payable at $30 per 15 minutes or greater part of 15 minutes.
  • Payable to a maximum of 2 units per patient per day.
  • Payable to a maximum of 100 units per physician annually.

For information on the Fee Code Program eligibility please see  program registration form. Please click here

  • The Fee Code Program is designed to encourage comprehensive patient care, with the eligibility criteria reflecting that goal.  The list includes some mandatory and an optional list of 4 out of 11 criteria.   We expect that many physicians with long-term relationships with their patients will satisfy the minimum, if not more, of the qualifying list. In cases where a physician needs supports to meet eligibility requirements, our program will be happy to work with that physician to provide the appropriate supports.
  • New fee codes are chosen in consideration of the following:
    • Codes that encourage and facilitate comprehensive care, improved patient access, increased coordination and collaboration between family physicians and other primary health care providers, improved health outcomes, improved recruitment and retention of family physicians, and improved patient-physician longitudinal attachment, particularly for those living with chronic disease(s).
    • Codes that have either proven their effectiveness in other jurisdictions or are widely believed to carry significant opportunity for positive impact in our province.
    • Codes that reflect the reality of our current system, and which have a true potential for uptake.
    • Codes that provide opportunities for early “proof of concept”, so that value of the program can be established.
  • The most robust evaluation data is available for BC. Chronic Disease Management (CDM) incentives in BC were associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for several of the groups for which CDM incentives were introduced: hypertension, chronic obstructive pulmonary disease, and congestive heart failure. [1]
  • After controlling for patients’ age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with chronic obstructive pulmonary disease (by Can$496), hypertension (by approximately Can$308 per patient), congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). [2]

[1] Hollander, Kadlec, 2015

[2] Hollander, Kadlec, 2015

  • Absolutely!  We always want to hear your ideas.  Please contact Glenda Nash, Program Director, at (709) 702-3701  gnash@nlma.nl.ca.