Virtual Visit Tariffs
Doctors Manitoba and Manitoba Health have agreed to introduce virtual visit tariffs during the pandemic, for use by all fee-for-service physicians. Virtual visit tariffs apply to patient encounters conducted via phone or video.
The following virtual visit tariffs can be used regardless of modality (phone or video). All tariffs will remain available during the pandemic response until Manitoba Health communicates they are no longer available.
It is important to ensure you are following both Manitoba Health and CPSM rules governing virtual visits. See our recent virtual visit reminders here (Feb 2023).
|Tariff||Virtual Visit Description||Effective Date|
|8321||Virtual Visit paid equivalent to bloc’s regional history or exam rate||Mar 14/20|
|8535||Consultation, paid equivalent to blocs’ 8550, 8553, 8556, 8516, 8617 or 8557||Apr 24/20|
|8527||Chronic care, paid equivalent to 8511 (e.g. PCH residents)||Apr 1/20|
|8655||Psychotherapy performed by a non-psychiatrist, paid at equivalent to 8580||Apr 24/20|
|8675||Group (2 or more patients) psychotherapy by a non-psychiatrist paid at equivalent to 8589||Nov 10/22|
|8533||Psychotherapy performed by a psychiatrist, paid at equivalent to 8581||Mar 14/20|
|8786||Psychiatric care, paid at equivalent to 8584||Apr 24/20|
|8668||Group (2−4) psychotherapy performed by a psychiatrist paid at equivalent to 8444||Nov 10/22|
|8669||Group (5+) psychotherapy performed by a psychiatrist paid at equivalent to 8446||Nov 10/22|
|8521||Consultation performed by a psychiatrist involving a child (less than 18) or geriatric (70 or older) patient, paid at a rate equal to 8554 or 8622||Apr 24/20|
|8284||Virtual visit with patient aged 65 – 69 years by general practitioner paid equivalent to 8425||Nov 1/20|
|8285||Virtual visit with patient aged 70 years and over by general practitioner paid equivalent to 8513||Nov 1/20|
Comprehensive Assessment Tariffs (Updated June 1, 2023)
Comprehensive virtual assessments are generally considered equivalent to an in-person complete exam, involving a full patient history with the same documentation requirements as a complete in-person exam. A comprehensive virtual assessment should not be claimed if an in-person visit follows the virtual visit. Based on the Manitoba Health tariff rules and feedback from physicians, for most episodic primary care encounters we would anticipate a virtual visit (tariff 8321) being the appropriate claim most of the time rather than a comprehensive virtual assessment.
Effective June 1, 2023, Comprehensive Virtual Assessments by phone or video (tariffs 8442 and 8447) can only be claimed where there is an established patient physician relationship. An established relationship means:
- The physician has provided at least one insured service with a direct physician encounter between the patient and that physician in the preceding 24 months; or
- The physician is providing a virtual visit service to a patient who is on the panel of another physician within the same practice group where the physician has access to the patient’s medical record; or
- The physician is providing services through an existing contractual arrangement with Manitoba Health, an SDO or under the Master Agreement, including but not limited to Specialist on Call coverage or coverage of a Rural Emergency Department; or
- The physician provides or has provided in the preceding 24 months rural and remote medical termination (tariff 8427).
Please note the rules above about established patient-physician relationship apply to comprehensive virtual assessments only, and do not apply to other virtual visit tariffs such as consultations or psychotherapy.
|Tariff||Virtual Visit Description||Effective Date|
|8442||Comprehensive virtual assessment by general practitioner paid equivalent to complete visit tariffs 8540, 8424 or 8500||Nov 1/20|
|8447||Comprehensive virtual assessment by specialist paid equivalent to complete visit tariff 8540, 8503, 8504, 8543, or 8544 for the bloc of practice.||Nov 1/20|
A full rate table is available for review.
The following common rules guide the use of all virtual visit tariffs:
- You may continue to bill for services provided by a Resident under your supervision in accordance with past practice.
- Services must be provided personally by the physician. No claim may be made for a virtual visit in which only a physician proxy participates, such as a nurse or clerk.
- After hours premiums may not be claimed in addition, except for established patients for urgent or emergency communications. (New, effective June 1, 2023)
- Start and Stop times must be documented in the patient’s chart and included on the claim.
- Rural/Northern/Brandon Fee differentials apply.
- Both the patient and the physician must be in Manitoba for the virtual visit. Exceptions have been approved by Manitoba Health for patients residing in Nunavut, Saskatchewan and Northwestern Ontario.
|DO conduct the visit yourself. Virtual visits by non-physicians are not covered. Where a Physician Assistant carries out part of the visit the physician must also see/speak with the patient.||DON’T use the new tariff for phone advice you would normally have provided following an in-person visit, such as sharing normal test results.|
|DO continue to provide PCH care in person, unless you are ill or required to self-isolate. You can continue to use tariff 8000 for calls from PCH staff.||DON’T claim comprehensive virtual assessments (8442 or 8447) unless the criteria described above is met (effective June 1, 2023)|
|DO claim interpretations of any diagnostic tests (e.g., Audiograms, EKG, EEGs…) that are usually billed in addition to visits under the applicable tariff in addition||DON’T claim a virtual visit on the same day as an in-person visit|
|DO include start and stop times in your documentation.||DON’T claim office/home visit tariffs for services provided virtually.|
|DO claim rural and northern premiums if both you and your patient are outside of Winnipeg||DON’T claim after hours premiums except for established patients for urgent or emergency communications. (New, effective June 1, 2023)|
If you have questions about virtual care and the new tariffs, please contact us at email@example.com.