Specialty Restricted Fee Codes – Eligibility
To claim the consultation or visit services listed on specialty visit/examination pages, or 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 that specialty bloc of practice by Manitoba Health.
From which visit/examination pages do you bill?
- If you’re a Physician and not assigned to a specialty bloc of practice, you must claim from the visit/examination pages for General Practice.
- If you’re a Specialist without a corresponding visit page (e.g., Radiology), you may claim from the General Practice visit page.
- If you’re a Specialist who is recognized in more than one specialty by the CPSM, you may only bill visit/examination fees for the bloc to which Manitoba Health has assigned you.
- Has Manitoba Health assigned you more than one bloc? You must bill under the specialty that is most appropriate for the condition being diagnosed/treated.
How does Doctors Manitoba assign members to Blocs?
- All practicing Doctors Manitoba members are assigned to the bloc that corresponds to the bloc assigned by Manitoba Health.
- Most physicians are assigned to the same bloc of practice as their specialty designation.
- 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).
- Physicians with a licence to practice limited to a specialty field who are not enrolled on the specialists’ register are assigned to General Practice’s bloc.