Conferences, Counselling and Psychotherapy

The General Schedule of the Physician’s Manual includes a number of conference, counselling and psychotherapy tariffs that compensate physicians for time spent discussing patient care and/or providing counselling/therapy.

These tariffs are:

  • 8474 Case Management Conference
  • 8473 Patient Care Family Conference
  • 8650 shared Care Conference
  • 8493 Manitoba Home Nutrition Patient Care Conference
  • 8585 Palliative Care Counselling
  • 8580 Psychotherapy – Individual
  • 8589 Psychotherapy – Group (two or more patients)

Each tariff has a distinct set of rules and guidelines that should be carefully reviewed to ensure that you are billing appropriately and efficiently. Most, but not all, of these tariffs may be claimed by all blocs of practice. (There are additional conference, counselling and psychotherapy tariffs listed on some visit pages in the Manual that may be claimed by the corresponding bloc of practice).

The following is a synopsis of the most important details respecting each of these tariffs:

Tariff 8474 Case Management Conference

  1. Purpose of conference must be to share information to better manage a patient’s care.
  2. Must be formally scheduled and pertain to one named patient. Consecutive formal scheduled conferences, each pertaining to one named patient, are permitted.
  3. All physicians in attendance at the conference may submit a claim.
  4. Paid for the first full 15-minute period and for each additional 15-minute period or major portion thereof.
  5. Maximum of one hour may be claimed per conference.
  6. Maximum of three conferences per patient per year. Additional conferences may be claimed By Report.
  7. Not intended to be used for routine rounds or grand rounds.
  8. May not be claimed by Psychiatrists or Physical Medicine Specialists.

Tariff 8473 Patient Care Family Conference

  1. Conference may include (but is not limited to) discussions about the condition and care of a patient with serious and complex problems, a catastrophic or terminal illness, developmental and multiple handicap disorders, or chronic pain. Conference may also include the assessment of the need of care from other providers and/or community agencies.
  2. Does not have to be formally scheduled.
  3. Patient may or may not be present at conference.
  4. Paid for the first full 15-minute period and for each additional 15-minute period or major portion thereof.
  5. Maximum of one hour may be claimed per conference.
  6. Maximum of twelve 15-minute sessions per patient per year. Additional conferences may be claimed By Report.
  7. May not be claimed by Psychiatrists or Physical Medicine Specialists.

For more detailed information on this tariff, please refer to the billing article Patient Care Family Conference – Tariff 8473.

Tariff 8650 Shared Care Conference

  • Conference is defined as a conference between a psychiatrist and other physicians, allied health professionals, educators, or appropriate community workers to share information to better manage a patient’s care.
  • Must be formally scheduled.
  • Tariff must be claimed in the name of the patient.
  • The Psychiatrist most responsible for the care of the patient and whose active participation in the conference (documented) may claim the tariff.
  • The General Practitioner most responsible for the care of the patient and whose active participation in the conference (documented) may claim the tariff.
  • Any other physicians participating in the conference may claim By Report.
  • In hospital “physician to physician” patient care conferences are excluded.
  • Maximum of one hour may be claimed per conference.
  • Maximum of 6 hours per patient may be claimed within any 12 month period.

Tariff 8493 Manitoba Home Nutrition Patient Care Conference

  1. Conference must be a formal scheduled conference relating to the care and treatment of a patient in the Manitoba Home Nutrition Program.
  2. Conference shall include a pre-assessment team conference with allied health professionals and a post-assessment conference with patient’s family and/or other care givers.
  3. Patient is not present at the pre-assessment conference but may or may not be present at post-assessment conference.
  4. Paid for the first full 15-minute period and for each additional 15-minute period or major portion thereof.
  5. Maximum of 60 minutes may be claimed per conference.
  6. Maximum of 12 conferences per patient per year. Additional conferences may be claimed By Report.
  7. A visit may be claimed in addition if a physical examination of the patient was performed.
Tariff 8585 Palliative Care Counselling
  1. Tariff applies to counselling to a patient with a terminal disease (e.g., cancer, AIDS, advanced neurological disease) and/or counselling to that patient’s family.
  2. Does not have to be formally scheduled.
  3. Generally, counselling will take place during a period not greater than 3 months prior to death. Where circumstances require a longer duration of palliative care, tariff must be claimed By Report.
  4. Paid for the first full 15-minute period and for each additional 15-minute period or major portion thereof.
  5. Counselling beyond one hour must be submitted By Report.

Tariff 8580 Psychotherapy – Individual

  1. Does not have to be formally scheduled.
  2. A minimum of a full 30-minute period and a maximum of 90 minutes may be claimed per patient per day.
  3. Paid for each of the first two full 15-minute periods and for each additional 15-minute period or major portion thereof.
  4. Where psychotherapy sessions with a single patient extend beyond a total of 2.5 hours in any 7-day period, a written report is required.
  5. Service may be provided following regular office visit. However, psychotherapy must be provided for a minimum of 30 minutes in addition to the time spent on the examination.
  6. May not be claimed by certified specialists in Psychiatry.

Tariff 8589 Psychotherapy – Group

(two or more patients)

  1. Group is defined as two or more patients together in a session and may include family members.
  2. Does not have to be formally scheduled.
  3. A minimum of a full 30-minute period and a maximum of 90 minutes may be claimed per session.
  4. Paid for each of the first two full 15-minute periods and for each additional 15-minute period or major portion thereof.
  5. Total fee listed for the group is to be divided by the number of patients in the group (rounded to the nearest cent) and billed for each patient on a separate claim.
  6. May not be claimed by certified specialists in Psychiatry.

Billing Note for Tariff 8473

  • A Patient Care Family Conference may immediately precede or follow a visit, however, claims submitted for the same date of service as a patient visit will require manual intervention for the claim to be processed.
  • It is a requirement that the start/stop times of the patient conference be noted in the patient chart.

    Where a conference immediately precedes or follows a patient visit, note the start/stop times of both the patient visit and the conference in the patient chart so that if their claims under this tariff are audited by Manitoba Health, it will be obvious to Manitoba Health that the conference took place at a separate time than the visit.

    For example, if a visit takes place from 9:00 to 9:10 a.m. and is followed by a Patient Care Family Conference that takes place from 9:10 to 9:25, the time requirements for claiming both tariff 8529 and tariff 8473 (for one 15-minute period) would be met. If the physician noted these start/stop times in the patient chart, it would clearly outline that two distinct services were provided at separate times.

Questions?

Roger Jamieson
rjamieson@docsmb.org
(204) 985-5849

 

Updated: December 2016