Changes to virtual care claim processing
Smoking cessation processing
Effective December 1, 2022, to be eligible for payment, the modality of an ‘E079A smoking cessation: initial discussion with patient’ claim must either match the modality of the required virtual care service or include no modality if provided in-person.
For example:
- If the service was provided in-person, the E079A and the required service must both be submitted without a video (K300A) or telephone (K301A)
- If the service was provided by video, the E079A and the required service must both be submitted with a video (K300A)
- If the service was provided by telephone, the E079A and the required service must both be submitted with a telephone (K301A)
If the modalities of the required service and the E079A claim do not match the E079A premium will be paid at $0.00 with explanatory code ‘DF – Corresponding fee code has not been claimed or was approved at zero’.
Palliative care special premium
All special palliative care consultation (A945A), special palliative care consultation (C945A), and palliative care support (K023A) services provided by eligible virtual modalities will now accumulate to the physicians’ service and patient count totals for the palliative care special premium payment.
This change is effective for all claims with a service date on or after December 1, 2022.
Click here for more information.
