Bcma Fee Schedule Gp 6d2z6o

WorkSafeBC-BCMA FEE SCHEDULE QUICK REFERENCE GUIDE FOR GENERAL PRACTITIONERS Agreement rates effective April 1, 2012 – March 31, 2014 FEE CODE

FEE ITEM

Rate as of May 08/11 ($)

Rate effective Apr 1/12 ($)

Rate effective Apr 01/13 ($)

49.03 34.32 33.00 22.00 55.00

49.72 34.80 33.46 22.31

50.46 35.32 33.96 22.64

55.77

56.61

40.28 18.02 29.68 14.84

40.84 18.27 30.10 15.05

41.46 18.55 30.55 15.27

40.80

41.37

41.99

1.22

1.24

1.26

25.50

25.86

26.24

122.40

124.11

125.98

68.53 actual cost

69.49 actual cost

70.53

300.90

305.11

309.69

265.20

268.91

272.95

15.30

15.51

15.75

76.50

77.57

78.73

FIRST REPORT OF INJURY (FORM 8) 19937 19938 19900 19901 19927

TELEPLAN E-FORM 8 received within 3 days TELEPLAN E-FORM 8 received within 4-6 days FAX FORM 8 received within 3 days FAX FORM 8 received within 4-6 days FORM 8 REQUESTED (when Form 8 was not initially required) received within 10 days from WorkSafeBC request PROGRESS REPORT (FORM 11)

19940 19941 19902 19903

TELEPLAN E-FORM 11 received within 3 days TELEPLAN E-FORM 11 received within 4-6 days FAX FORM 11 received within 3 days FAX FORM 11 received within 4-6 days CLINICAL RECORDS

19904 19906 19905 19953

WCB REQUEST FOR A COPY OF AN EXISTING REPORT up to 20 pages, received within 3 days ADDITIONAL CHARGE PER PAGE for over 20 pages (continuation of code 19904) WCB REQUEST FOR A COPY OF AN EXISTING REPORT first 5 pages or less sent by mail WCB REQUEST COPY OF AN EXISTING REPORT OR CHART NOTE - Isolating relevant information, severing irrelevant information unrelated to claim. 19904, 19905 or 19906 may not be billed in addition. Must be received within 10 days of request of service and includes all courier charges if applicable. EMERGENCY VISITS AND TRAY SERVICE

00129 19922

WCB EMERGENCY CALL OUT TRAY SERVICE materials used in conjunction with sterile tray fees. Bill the actual cost of materials.

actual cost

RETURN TO WORK PLANNING 19942

19950

19976

JOB SITE MEETING When a physician has been requested by the WorkSafeBC case manager to attend a meeting at the worker’s job site. This is a flat fee and no other expenses will be paid in addition to this fee. The rate is based on a time commitment of 3.5 hours and includes travel time. RETURN TO WORK CONSULTATION bundled fee item Can be initiated by Board officer or delegate, Board physician, employer or treating physician. Can occur as early as the first office visit. Must include consultation by physician with employer & Board officer AND follow up with worker. Consultation and RTW plans must be documented and submitted on Form 11. Form 11 fee is billable in addition. RETURN TO WORK REQUEST Initiated by a Board officer or a designated rehabilitation provider to a physician to endorse a return to work planning request form. COMPREHENSIVE ASSESSMENTS

19909

STANDARDIZED ASSESSMENT FORM Upon request by WorkSafeBC, received within 15 days

Health Care Services Updated April 2014

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FEE CODE 19910 19929

19907

19932

19933

FEE ITEM STANDARDIZED ASSESSMENT FORM Upon request by WorkSafeBC, received after 15 days EXCESSIVELY PROLONGED OR COMPLEX CASE Report received within 20 business days of service. At WorkSafeBC request, a physician will review the file, examine the injured worker, and develop a report on an Injured Worker whose recovery is prolonged or complicated. FACTUAL WRITTEN SUMMARY OR REASONED MEDICAL OPINION Upon request by WorkSafeBC. 19904 may not be billed in addition. MEDICAL-LEGAL REPORT Include history and physical, diagnosis, summary of interventions & outcome. This is a factual summary of all clinical information. Requires prior approval by Senior Board Officer. MEDICAL-LEGAL OPINION Expert opinion. Includes information contained in the medical-legal report, but will also include opinion in field of expertise with respect to prognosis - long term consequence, possible complications in the further development of condition. Requires prior approval by Senior Board Officer.

Rate as of May 08/11 ($)

Rate effective Apr 1/12 ($)

Rate effective Apr 01/13 ($)

71.40

72.40

73.49

132.60

134.46

136.47

260.10

263.74

267.70

873.12

885.34

898.62

1458.60

1479.02

1501.21

57.12

57.92

58.79

51.00

51.71

52.49

72.42

73.43

74.54

150.00

152.10

154.38

100.00

101.40

102.92

200.00

202.80

205.84

N/A

N/A

277.47

N/A

N/A

134.94

COMMUNICATION 19919 19930

19508

OFFICE CONSULTATION with Board Officer or designate. TELEPHONE CONSULT with Board Officer (e.g. Case Manager or Nurse Advisor) to discuss case management – in 15-minute increments, up to 45 minute daily maximum. Cannot be billed for routine enquiries. PRE-ARRANGED TELEPHONE CONSULTATION between a WorkSafeBC Medical Advisor and a community Physician within 24 hours of being initiated by the Medical Advisor. COMPLEX SPINAL CORD INJURY

19509

19510

19511

COMPLEX SPINAL CORD INJURY INITIAL VISIT OR YEARLY ASSESSMENT Includes a complete physical exam, updated care plan documented on a Form 8/11. Paid annually to noted regular physician. Form 8/11 will be paid in addition. COMPLEX SPINAL CORD INJURY OFFICE VISIT For all other office visits following 19509; cannot bill in addition to a yearly assessment fee (19509) for same visit. Form 8/11 will be reimbursed if changes in condition. COMPLEX SPINAL CORD INJURY HOME VISIT The physician must also complete and bill for a Form 8/11. This fee cannot be billed with office visit (19510) EXPEDITED COMPREHENSIVE CONSULTATION

19945

19946

EXPEDITED COMPREHENSIVE CONSULTATION FROM A PHYSICIAN WITH AREA OF EXPERTISE Only when requested by WorkSafeBC. Need prior approval REPEAT EXPEDITED COMPREHENSIVE CONSULTATION FROM A PHYSICIAN WITH AREA OF EXPERTISE Repeat comprehensive consultation after 19945.

Health Care Services Updated April 2014

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