Specialty Restricted Fee Codes – Eligibility

In order to qualify for claiming the consultation or visit services listed on specialty visit/examination pages and for other specialty restricted tariffs in the Physician’s Manual, a physician must be named on the specialist register of the College of Physicians and Surgeons of Manitoba (CPSM) and be assigned to a specialty bloc of practice by Manitoba Health.

Physicians who are not assigned to a specialty bloc of practice must claim from the visit/examination pages for General Practice.  In addition, specialists without a corresponding visit page (e.g., Radiology) must also claim from the General Practice visit page.

A specialist who is recognized in more than one specialty by the CPSM may only bill visit/examination fees for the bloc to which he/she has been assigned by Manitoba Health. The few physicians who have been assigned to more than one bloc by Manitoba Health must bill under the specialty that is most appropriate for the condition being diagnosed and/or treated.

Question: How does Doctors Manitoba assign members to Blocs?
Answer: All practicing Doctors Manitoba members are assigned to the bloc that correspond to the bloc assigned by Manitoba Health.  Thus, most physicians are assigned to the same bloc of practice as their specialty designation.  However, some physicians with sub-specialty designations will be assigned to a broader specialty bloc of practice (e.g., infectious disease specialists and endocrinologists may be assigned to the bloc of Internal Medicine).  As well, physicians with a licence to practice limited to a specialty field who are not enrolled on the specialists register are assigned to the bloc of General Practice.
Questions?

Ian Foster
ifoster@docsmb.org
(204) 985-5854

 

Updated: November 2016