Search

New tariffs have been implemented for real-time, or synchronous, phone or video conversations between physicians and from other designated providers. The purpose of the communication is for a referring physician to seek the advice of a physician with expertise in treating a presenting problem, with the referring physician or provider continuing to care for the patient. Compensation is available for both the physician initiating the communication and the physician receiving the communication. 

Tariff 8356 is to be claimed by the physician initiating the call.

Tariff 8355 is to be claimed by a consultant physician who receives a call from another physician or other designated health care providers. The full list of other eligible health care providers is set out in the tariffs notes below.

The tariffs are only claimable for telephone or video conference services, happening in real-time. See our overview of communication tariffs for others that support email/​fax communication between physicians, and phone/​email/​fax with other providers.

8355
Telephone/Videoconference communications to a consultant initiated by another physician, RN (EP), Physician Assistant (PA), Clinical Assistant (CA), midwife or designated allied health provider – Consultant Physician $50.00
8356
Telephone/Video Conference communications to a Consultant Physician – Referring Physician $25.00

Tariff 8355 and 8356 may be claimed by:

i) A Specialist for communications from a Specialist, General Practitioner, RN (EP), Physician Assistant (PA), Clinical Assistant (CA), or midwife regarding a patient who is receiving medical care from the Physician or RN (EP) who initiated the communication; and

ii) A General Practitioner for communications from a General Practitioner, RN (EP) Physician Assistant (PA), Clinical Assistant (CA), or midwife regarding a patient who is receiving medical care from the Physician or RN (EP) who initiated the communication.

iii) A General Practitioner with expertise in Addictions Medicine, Palliative Care, Care of the Elderly, Anesthesia or Obstetrics, from a Specialist, General Practitioner or RN (EP) regarding a patient who is receiving medical care from the practitioner who initiated the communication.

iv) A General Practitioner or Specialist (Internal Medicine, Neurologist, Cardiologist, Plastic Surgeon, Urologist, Orthopaedic Surgeon, Neurosurgeon, Otolaryngologist or

Dermatologist) from a Dentist/​Oral Surgeon regarding a patient who is receiving medical care from the Dentist/​Oral Surgeon who initiated the communication.

v) An Ophthalmologist for communications from an Optometrist. 

vi) An Otolaryngologist for communications from an Audiologist.

vii) The consultant may not claim a major consultation or procedure for the same patient for the same condition within 24 hours unless the patient was transferred from an outside facility and advice was given on management of that patient prior to transfer. 

viii) May only be claimed when the consultant has provided an opinion and recommendation for patient treatment, and management after reviewing pertinent family/​patient history of the presenting complaint, and discussion of the patient’s condition and management after reviewing laboratory and other data where indicated,

ix) The purpose of the call is to seek the advice of a physician more experienced in treating a presenting problem. It is the expectation that the referring physician, nurse practitioner, midwife or podiatric surgeon will continue to care for the patient. 

x) May not be claimed for situations where the purpose of the call is to 

  • Arrange for an expedited consultation or procedure within 24 hours except when the conditions are met
  • Arrange for laboratory or diagnostic investigations
  • Discuss or inform the referring physician or podiatric surgeon of results of diagnostic investigations.

xi) a maximum of any two 8355, 8356 claims may be claimed per patient, per physician per day. 

xii) Documentation must be recorded by both the referring physician, RN (EP) or designated allied health provider and the consultant in their respective records.

xiii) Physician billing 8355 can not be the supervising physician of the Physician Assistant (PA) or Clinical Assistant (CA).

Last updated
September 29, 2023