The new Virtual Care Pilot fee codes for specialists became available effective June 1, 2021. Sixty-five new specialist section-specific codes are implemented replacing the 510A/515A and 350A-358A temporary pandemic fee codes. Psychiatry virtual certification codes are not part of this phase as it was mutually agreed further consultation with the Section of Psychiatry and amendments to The Mental Health Services Regulations are required.
Virtual care provides physicians with flexibility and has shown itself to be an essential mode of care during the pandemic. These new virtual care codes are intended to better reflect the comprehensive services being provided to patients and supplement the in-person insured service codes. Prices for virtual care services were negotiated and subsequently ratified by the membership at 90 per cent of the April 1, 2020, in-person service code fee. Both physician and patient can initiate the phone/video calls and both must be physically located in Saskatchewan at the time of the virtual service.
Effective June 1, 2021, the existing pandemic virtual care codes 350A-358A and 510A/515A will not be payable for services provided after May 31, 2021, and specialists are to use the Virtual Care Pilot codes. For services provided up to May 31, 2021, specialists will be able to submit their billings using the pandemic fee codes 350A-358A and 510A/515A (the six-month limit to submit billings applies).
The pilot program for virtual care codes was negotiated as part of the recently ratified agreement between the Ministry of Health and the SMA. The pilot program will be reviewed for appropriateness prior to March 31, 2022.
Effective January 1, 2021 the new Virtual Care Pilot fee codes for Family Practice became available, replacing the 510A/515A pandemic fee codes for family physicians. To align with temporary pandemic service codes 510A/515A, the 805B/855B prices were temporarily set at $35 and will revert to the originally ratified rate of $31.85 effective June 1, 2021.
During the pandemic, the Ministry agreed to waive the 3,000-service limit to allow physicians the opportunity to provide more services virtually, particularly when residents were being encouraged to stay home whenever possible. Effective July 19, 2021, the Ministry enabled the 3,000 per year service limit on a prorated basis. This means irrespective of the number of virtual care services that a physician has billed prior to July 19, 2021, a physician can bill up to 1,375 virtual services provided from July 19, 2021 to December 31, 2021. The service limit of 875A (Limited virtual care visit) is also being prorated. Inclusive of the 1,375 maximum, a maximum of 687 services are payable via 875A from July 19, 2021 to December 31, 2021. At the turn of the calendar year, the 3,000 service limit will reset.
The Medical Services Branch will also be issuing a letter to physicians when they reach 80% of the Virtual Care Pilot service billing limit. However, physicians are encouraged to check how many virtual services they have billed from their EMR and from that calculate the number of remaining billable units. Physicians are also encouraged to submit their billings in a timely manner (the six-month limit to submit billings applies).