Extended Hours for Primary Care
The New Physician Services Agreement includes the permanent implementation of the extended hours premium for primary care. Family Medicine and Pediatric clinics that extend their hours are eligible to access a 20% premium for services provided.
- The extended hours premium focuses on primary care and is available for Family Physicians (general practice) and Pediatricians.
- Most Services 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 to accept walk-in appointments.
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 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 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.
- 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||Description||Rate (as of Feb 1, 2023)|
|5530||Add for extended clinic hours weekdays: 0600 – 0800 (6:00 am to 8:00 am) or 1700 to 2359 (5:00 pm to 11:59 pm)||20% to payable fee|
|5531||Add for extended clinic hours weekends/holidays: 0701 to 2359 (7:01 am to 11:59 pm)||20% to payable fee|
We encourage you to retain a copy of any materials you create to promote or advertise your extended hours, in the event your billings are audited.