Update on Virtual Visit Tariff Changes — Date Change

Last week, we sent a notice about some changes to the temporary virtual visit tariffs. The changes were slated to come into effect on June 1, and we asked for your feedback about how the changes would impact your practice. Based on this feedback, we have worked with the government to change the effective date to July 4, 2023. This will allow time to further assess the impact and add further clarity to the tariff language that this change is not meant to penalize physicians who established a patient relationship virtually during the pandemic period. 

What is changing?

The existing virtual visit tariffs are still temporary, having been introduced for just the pandemic period and with a proviso that they could be canceled at any point by Manitoba Health. The clarifications communicated to you last week made two changes to the existing temporary virtual visit tariffs:

  1. Comprehensive virtual visit tariffs (8442 or 8447) can only be claimed when there is an established patient-physician relationship, meaning an in-person visit within the last two years (with few exceptions). 
  2. After hours premiums for virtual visits could only be claimed for established patients for urgent and emergency communications. 

These changes will not affect any in-person tariffs. All other virtual tariffs, including a regular virtual visit (8321) and consultations (8535), continue to be paid at 100% of the in-person rate with no requirement for an existing patient relationship. 

You can read the full detail about the changes here.

When will the changes take effect?

We have worked with the government to change the original effective date of June 1 to July 4, 2023.

Why is the date changing? 

The date change is a direct response to concerns raised from physicians who felt the new tariff language penalized them for essentially following pandemic guidance that encouraged virtual care to slow the spread of COVID-19. By following those guidelines, many physicians established or continued patient relationships virtually during the last two years. Their concern is the language unintentionally penalizes them for following clinical guidance from Shared Health and the province about shifting away from in-person care during the pandemic. 

The additional month will provide more time for Doctors Manitoba and Manitoba Health to further assess these concerns and avoid this unintentional impact.

Our advice on virtual visits

Virtual visits were introduced during the pandemic across Canada, and generally at the equivalent rate to in-person visits. Most provinces have since introduced permanent virtual visit remuneration structures in which virtual visits are paid at a reduced rate or an equivalent rate to in-person care, but not more. In some cases, provinces pay a lower rate for virtual visits when care is episodic or walk-in in nature, and a full rate a virtual visit is delivered to an established patient. You can see our summary here of provincial trends from last week’s message.

Seeing this trend across Canada, it is no surprise to us that Manitoba Health would pursue changes to the existing pandemic virtual visit rates. Our primary focus has been on protecting virtual visits and pushing for a permanent solution that is optimal for all physicians and the patients they serve as part of the Master Agreement negotiations. 

Physicians who have primarily used a comprehensive virtual assessment rather than a regular virtual visit are encouraged to carefully review the rules and their practice to assess if a change is required. Among family physicians generally, regular virtual visits (8321) are used nearly nine times more often than a comprehensive virtual assessment (8442). Comprehensive virtual assessments have the same tariff requirements as a complete in-person exam, including a full patient history. As we communicated in February: Based on the Manitoba Health tariff rules and feedback from physicians, for most episodic primary care encounters we would anticipate a virtual visit (tariff 8321) being the appropriate claim most of the time rather than a comprehensive virtual assessment.”

Please continue to contact us at practiceadvice@​doctorsmanitoba.​ca to help us understand how this change would affect your practice. We also want to know how changes adopted in other provinces would affect your practice. You can read our summary of these changes here.