New Rule of Application for Virtual Medicine
1. A Virtual Medicine Visit is a medical service provided to a patient by a physician by telephone or video. Telephone means synchronous audio-only communication (no visualization); and video means 2‑way synchronous video-conference (audio and video visualization)
2. For the purposes of claiming Virtual Medicine Visits, continuing patient relationship means:
i) The physician has provided at least one insured service for the patient in the preceding 24 months; or;
ii) The patient is on the panel of another physician within the same practice group who has provided at least one insured service to the patient in the preceding 24 months and the physician has access to the patient’s electronic medical record; or;
iii) The physician is providing services through a contractual arrangement with Manitoba, a Health Authority or under the Physician Services Agreement including but not limited to Specialist On-Call coverage or coverage of a Rural or Northern ED; or;
iv) The patient has been referred to the physician from another health care provider or health care service in Manitoba; or;
v) The virtual medicine visit is for the purpose of psychiatric care or psychotherapy.
3. Virtual Medicine Visits may be claimed subject to the following:
a) Services must be personally rendered by the physician, i.e., no claim may be made for a virtual medicine visit in which only a physician proxy, e.g., nurse or clerk, participates.
b) Maximum of one virtual visit per patient per day may be claimed.
c) The patient and the physician must both be located in Manitoba at the time of service, except where otherwise authorized by the Provincial CMO or designate.
d) After Hours Premiums may only be claimed when there is a continuing patient relationship as described above and the visit is an urgent or emergent service,
e) Medical services provided must be documented and such documentation may be requested by Manitoba, to support the claim submitted.
f) Geographical fee differentials shall apply in addition. The geographical fee differential shall be determined by the average of the fee differential applicable to the patient’s location and applicable to the physician’s location.
g) Where, during the course of the virtual visit, it is determined an in-patient assessment is necessary, the physician may bill a Basic or Intermediate virtual visit as appropriate. The subsequent in person visit may be billed at the appropriate in-person examination tariff in addition.
Other Important Notes
It is important to ensure you are following both Manitoba Health and CPSM rules governing virtual visits.
We recommend reviewing CPSM’s information to ensure your approach to virtual medicine follows their standards.
- The Standard of Practice for Virtual Medicine, available through this page. You will notice CPSM emphasizes that “each member’s practice of medicine must include timely in-person care when clinically indicated or requested by the patient. It is not an acceptable standard of care to solely practice virtual medicine. A blended model of care balancing in-person and virtual medicine is required if providing virtual medicine.”
- An information sheet on practicing virtual medicine across provincial or international borders. This includes Manitoba physicians looking to offer virtual visits to patients outside of the province, and out-of-province physicians.
Like any other care physicians deliver, CPSM may receive complaints and investigate concerns about the provision of virtual medicine.