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Tariff 8002 is claimable for monitoring the condition of a patient receiving anticoagulant drug therapy. 

The guidelines/​requirements of this tariff are as follows:

  1. The tariff is a monthly fee (not a visit fee) and should be billed once per calendar month for each patient receiving anticoagulant therapy.
  2. The tariff is intended to compensate physicians for the ongoing responsibility of monitoring the condition of the patient and includes the provision of the following services:
    1. ordering blood tests;
    2. interpreting results
    3. inquiry into possible complications
    4. adjusting the dosage of anticoagulant (if indicated).

      These services may be provided via telephone, facsimile or email communications. However, a claim under Tariff 8002 does not have to correspond to a particular communication”. For example, in a given month, the monitoring of a particular patient might consist of only a review of lab results, with no communications” respecting the patient taking place. In another month, the monitoring of that patient might entail several communications” (either by telephone, facsimile or email) between the physician and/​or their office staff and the patient, a pharmacist, family members etc. Tariff 8002 is payable in each of those months.
  3. Claims for additional services rendered to the patient (e.g., visits) may be claimed in addition to the tariff.

Billing Notes

Tariff 8002 applies to hospital in-patients, Personal Care Home residents and at-home patients.

Tips for ease of billing:

  • Choose a day of the month (e.g., 1st day of month, last day of month etc.) and bill Tariff 8002 with respect to all patients receiving anticoagulant therapy on this same day each month.
  • Bill Tariff 8002 on a quarterly basis for patients receiving anticoagulant therapy, indicating the service date for each month for which they are billing. 
  • Elect to claim the tariff with a service date on the 1st (or last) Saturday or Sunday (non-office day) of each month, so as to avoid the possibility of the selected service date coinciding with the date of a patient visit, which can sometimes result in a failed” claim.
  • Tariff should be claimed by the physician most responsible for monitoring the patient’s condition respecting the anticoagulant therapy.

Examples:

  • A hospital in-patient is placed on anticoagulant therapy by a specialist, and is thereafter discharged to the community under the care of a family physician. The physician who should claim under the tariff is the physician who was responsible for monitoring the condition of the patient with respect to the anticoagulant therapy for the majority of the particular month.
  • Where the hospital in-patient has undergone major surgery, and where it is the surgeon who is responsible for monitoring the condition of the patient with respect to the anticoagulant therapy for the majority of that particular month, the surgeon may claim this tariff, despite the fact that the service date may fall within the three-week post operative period.
Last updated
July 26, 2024