Physicians are now able to bill for delegated immunization and therapeutic injection services provided by competent staff in their practice.

The Rules of Application pertaining to immunizations are amended to allow for physicians to bill fee-for-service when clinic staff provide immunizations to patients in a community-based clinic. The relevant wording change is as follows:

These benefits under this section are for the procedure alone and not for the management of the case. Where therapeutic injections or immunizations are provided in a community-based clinic, physicians may bill when the service is provided by a staff member employed and paid by the physician and competent to perform the service.

This advancement is as a practical change to allow physician practices to reach more patients with immunization in a team-based care environment. 

IDTI nurses:
IDTI nurses are already government funded. Because of this, Manitoba Health would not reimburse the physician for unsupervised immunization delegation. Similar to working with CA/PA’s the physician may bill if they have direct patient contact and are available in the event of an adverse patient reaction to the immunization.

Visits and Immunizations

Whether or not the immunization itself is delegated, a visit may be claimed in addition only if:

1. The patient receives the immunization at the same time as he/​she is being assessed for a condition or illness, or
2. Prior to administering the immunization, the physician discusses with the patient the suitability of receiving the vaccine, possible adverse reactions and obtains the patient’s informed consent.

See billing article Flu Shots – Seasonal Vaccinations for additional learning.