Beginning February 1, 2023, the government has agreed to offer a 20% premium for family medicine and pediatric clinics that extend their hours. The aim is to open up more primary care access for Manitobans, given the shortages in primary care and to alleviate some pressure on overwhelmed hospitals.

Summary:

• The extended hours premium focuses on primary care and is available for Family Physicians (general practice) and Pediatricians.
• Visits offered during the extended hour period will receive the 20% premium. It is important to review the rules the government has set for what qualifies as an extended hour period.
• Participation is optional. There is no expectation that physicians participate, and there is no on-going commitment either. 
• Extended access can be offered to your existing patients only, and/​or you can open up to accept walk-in appointments.

If you choose to participate, here are the relevant details. Doctors Manitoba staff are available to provide further advice on how to implement extended hours in your practice.

Requirements

The following requirements are in place to qualify for the 20% extended hours premium:

1. Extended hours cover the following periods outside of Mon-Fri 8:00AM — 5:00PM:

• Weekdays: early morning (6:00AM — 8:00AM) and evenings (5:00PM ‑11:59PM)
• Weekends and Recognized Holidays: 7:00AM — 11:59PM

2. Clinics cannot simply shift their existing hours into the extended hour periods to qualify. The clinic must be open a minimum of 8 hours Mon-Fri between the standard operating hours of 8:00AM and 5:00PM (e.g. 8 – 4, 830 – 430 or 9 – 5).

3. The hours apply to the clinic and its physicians collectively (e.g. hours of operation), and not to physicians individually. Physicians who work part time hours can participate in extended hours.

4. The extended hours must include in-person visit availability. Virtual visits can also qualify, but if you offer virtual visits only during the extended hour period, it will not qualify. 

5. Extended hours can be offered to your existing patient roster and/​or opened up for walk-in patients. There is no requirement to open it up for walk-in access, that is optional.

6. The extended hours must be advertised or promoted in some way. If you are opening extended hours for your existing patients only, this could include a poster, a post on your website, or a mass email message, for example. If you are opening up walk-in access, you could promote the availability through Medimap or some other method too.

Note: Holiday is defined in the tariff and includes any days recognized in lieu of a holiday by Manitoba Health.

Compensation

• A 20% premium applies to essentially all services you might provide in office, including visits, virtual visits, tests, immunizations, procedures and tray fees. 
• Clinics that are already open during the extended hours periods and meet the above criteria also qualify for the premium. In other words, this does not have to be net new extended hours to qualify. 
• Physicians will claim the usual visit or procedural tariff (e.g. an 8529), and for each service also submit the appropriate extended hours tariff for the designated extended hours period. This will be the same type of process that is currently used when claiming after hours premiums.
• Exclusions: The following do not qualify for the extended hours 20% premium, but can be claimed during the extended hours period as per existing practice:
  • Phone communication tariffs (8000−8005)
  • CDM/CCM Tariffs
  • After hours premiums currently available for urgent/​emergency services during similar time periods. Physicians should continue to bill after hours premiums for urgent and emergent services.

Tariff Information

Additional Advice

• Please let Doctors Manitoba know if you plan to participate and claim extended hours premiums. This will help us track uptake and support our continued advocacy for you. Send us details to practiceadvice@​doctorsmanitoba.​ca.
• Retain a copy of any materials you create to promote or advertise your extended hours, in the event your billings are audited.