Effective January 1, 2021 the new Virtual Care Pilot fee codes for Family Practice are available, replacing the 510A/515A pandemic fee codes for Family Physicians. Virtual care provides physicians with flexibility and has shown itself to be an essential mode of care during the pandemic. These new Family Physician virtual care codes are intended to better reflect the comprehensive services being provided to patients. This pilot program for virtual care codes was negotiated as part of the recently ratified Agreement between the Ministry of Health and the SMA. These new virtual care codes supplement the in-office family physician fee codes and will be reviewed for their appropriateness prior to March 31, 2022.
Specialist Virtual Care Pilot fee codes are anticipated for spring of 2021. Until advised otherwise, specialists are to continue using the existing Pandemic Virtual Care fee codes including 510A/515A.
For virtual care services provided between March 13, 2020 and December 31, 2020, Family Physicians are to use 510A/515A service codes.
NOTE: The Ministry of Health and the SMA have mutually agreed to suspend the maximum limit of 3,000 Virtual Care Pilot services per physician per calendar year, until further notice.
Virtual Care Pilot Assessment Rules
General Services - Section A
875A Limited Virtual Care Visit (Patient to Physician)
General Practice - Section B
805B Virtual Partial Assessment or Virtual Subsequent Visit
855B Virtual Partial Assessment or Virtual Subsequent Visit involving a Specialist
809B Virtual Consultation
840B Virtual Counselling first 15 Minutes
841B Virtual Counselling next 15 Minutes
864B Virtual Chronic Disease Management
Virtual Care Pilot service codes are EMR eligible where applicable (i.e. consistent with existing visit services eligibility). 875A is not EMR eligible.