Surgeons and Anesthesiologists – BMI Supplements for Morbidly Obese Patients

Advances to the Body Mass Index (BMI) Supplement were created to recognize the additional work involved in providing services for patients who are morbidly obese.

BMI supplemental payments are claimable by the primary surgeon and the primary anesthesiologist for certain eligible surgical services on morbidly obese patients. 

To claim a BMI supplement:

• The primary Anesthetist may claim Tariff 0050.
• Tariff 0050 is payable in addition to:
  • Anesthetic services listed in Appendix A of the Physicians Manual
  • Special Invasive Anesthesia Services
  • Tariff 5311, 5319 and 4877

• Tariff 0050 is not payable in addition to other catalogue items within the Anesthesia Section, such as Chronic Pain, Acute Pain, or Appendix B (excluding tariffs 5311,5319 and 4877 noted above).

For purposes of these tariffs, Morbidly Obese patients are adults with a BMI greater than 40 or a BMI greater than 45 if pregnant.
For patients under 18 years of age, the supplements may be claimed for patients above the 97^th percentile for BMI based on an approved paediatric growth curve.

Billing Note:

• Only one supplement may be claimed per patient per day by each primary Surgeon and the primary Anesthesiologist. If more than one eligible surgical service is provided, claim the supplement associated with the highest value surgical service.
• The patient’s weight, height, and BMI must be included with your claim and documented in the OR report.
• For hysterectomy services, claiming the BMI supplement may not be in conjunction with claims for Tariff 4620.
• To determine the appropriate surgical assistant benefits for the first surgical assistant, include the BMI supplement when deciding the principal surgeon’s total benefits. The BMI supplement is not included when determining the benefit for a second surgical assistant.
• After Hours or Out of Hours Premiums do not apply to BMI supplements.