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Doctors Manitoba Advice on Virtual Care Across Borders

A silver lining of the pandemic has been the rapid adoption and growth of virtual medicine has been beneficial for physicians and patients alike. However, patients may have high expectations about accessing care while working, studying, or travelling outside of Manitoba. Practicing virtual medicine across borders raises licensing, insurance liability, and billing issues. 

Any physician practicing virtual medicine should be familiar with the direction of The College of Physicians and Surgeons of Manitoba. The Standard of Practice for Virtual Medicine was most recently updated effective September 29, 2022. The Standard, together with updated Contextual Information and Resources, Frequently Asked Questions, and Information on Virtual Medicine Across Provincial and International Borders, can be found here.

The CPSM’s primary rule is easily understood: the location of the patient determines where the practice of medicine occurs. 

There are certain limited exceptions to this rule, which may allow Manitoba physicians to practice virtual medicine for some patients located outside of Manitoba.

There is already an agreement between Manitoba and Nunavut which allows Manitoba physicians to provide care, including virtual medicine, to Nunavut residents and be paid through reciprocal billing. Physicians should use existing virtual medicine tariff codes. Please note that geographic virtual visit premiums are not eligible for patients located outside of Manitoba. This is consistent with fee differential language in the Physician’s Manual. 

Manitoba physicians may continue to provide virtual medicine to their patients located in Northwestern Ontario and Saskatchewan. Manitoba Health confirms these virtual medicine appointments can be billed. Physicians should use existing virtual medicine tariff codes. We recommend you check with CPSO/CPSS regarding licencing requirements. Additionally, we recommend physicians do not provide virtual services where there is no pre-existing patient relationship.

Physicians should not provide virtual medicine appointments to patients located outside of Canada. The tariff codes for virtual medicine may not be used for any Manitoba patient located in the United States or any other country. Manitoba Health will only pay for virtual visits where the patient and physician are both located in Manitoba.

Doctors Manitoba understands the combination of licensing, insurance and billing issues may seem restrictive to some patients and some members. We are here to help with your virtual care questions.

See our article on Approved Virtual Visit Tariffs