Virtual Care
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. Please see below for the highlights of the pilot program and download the payment schedule.
Highlights of the pilot program:
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.
There is a maximum limit of 3.000 virtual care services (i.e. total sum of telephone and video visits, including limited virtual care visits 875A) payable per physician, per calendar year. At the turn of the calendar year, the 3,000 limit will reset.
Please note that limited virtual care visits code (875A) cannot exceed 1,500 per physician per year and are included in the 3,000 limit.
For time-based codes, only the base service code counts toward the annual service count limit (i.e. time modifiers are not counted). Please click here for the list of virtual care codes that are counted toward your limit.
The Medical Services Branch will issue a letter to physicians when they reach 80% of the Virtual Care Pilot service 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).
Would you like to know how many virtual care services you have already billed so far within this calendar year? Click below to learn how to run a report in your EMR:
The pilot program for virtual care codes was negotiated as part of a recently ratified agreement between the Ministry of Health and the SMA. The pilot program is expected to be reviewed conjointly by the parties.
Background:
Specialist Virtual Care Pilot Codes
Update effective June 1, 2021
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.
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).
Family Practice Virtual Care Pilot Codes
Update effective Jan. 1, 2021
Effective Jan. 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.
Update effective July 19, 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 Dec. 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.