The Physician Services Agreement included the permanent implementation of the extended hours premium for primary care. Family Physicians and Pediatric clinics that extend their hours are eligible for an add on premium between 20 – 30% for services provided within extended hour periods. 

Recent changes have been made for eligible physicians working extended hours to reflect the system need for after hours primary care. This includes:

• A new 30% premium for evenings of weekends and designated Holidays for, including Friday. See below for applicable rates.
• Premiums eligible for physicians participating in new Extended Hours Primary Care Clinics.

All clinics currently providing extended hours services on Saturday, Sunday and designated Holidays between 0700 – 1659 should use tariff 5530 (20% premium). Services provided between 1700 – 2359 on Friday, Saturday, Sunday and designated Holidays should be billed using tariff 5331 (30% premium).

Premium summary:

• The extended hours premium focuses on primary care and is available for Family Physicians and Pediatricians.
• Most Services offered during the extended hour period will receive the premium. It is important to review the rules that 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. 
• Extended access can be offered to your existing patients only, and/​or you can be open 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. 

See here for more information on SDO approved Extended Hours Primary Care clinics.

Requirements:

The following requirements are in place to qualify for the 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), evenings (Mon-Thurs) (5:00PM 11:59PM) and daytime weekends/​designated Holidays (7:00AM – 4:59PM)
• Weekend evenings (Fri-Sun) and Recognized Holidays: 5:00PM — 11:59PM
  • A list of Recognized Holidays and the days they will be observed for the current year can be found HERE.

2. The clinic must a) maintain at least 8 hours of regular office hours within 0800 – 1700 Monday-Friday or (b) operates as an SDO approved Extended Hours Primary Care clinic (EHPCC).

• Concordia (Casting Clinic)
• Seven Oaks (Northern Connections Medical Centre)
• Grace (Access Winnipeg West)
• St. Boniface (Ground Floor Oncology Clinic)
• Victoria/​Fort Gary (TBD)

3. 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).

4. 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.

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

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

7. 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, as examples. If you are opening walk-in access, you could promote the availability through Medimap or some other methods too.

Compensation:

• Extended clinic hours premiums apply to most services provided in an office, including visits, virtual visits, tests, immunizations, procedures and tray fees.
• Overview of remuneration information for EHPCC’s can be reviewed in our Extended Hours (Evening/​Weekend) WRHA Clinics article. 
  
• 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 process currently used when claiming after hours premiums.
• Exclusions: The following do not qualify for the extended hours premiums, but can be claimed during the extended hours period as per existing practice:
  • Phone/​video communication tariffs
  • Prescription renewals
  • CDM,CCM, FM+ 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.

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.