GP-Nurse Practitioner Advice Fee Code

Dec 5, 2014

The GPSC is pleased to introduce a new fee code, 14019, that supports collaboration between family physicians and nurse practitioners (NPs).

Guided by physician voices, the GPSC is pleased to introduce a new fee code, 14019, that supports collaboration between family physicians and nurse practitioners (NPs).

The new $40 fee code will be effective January 1, 2015. Funding has been approved to December 31, 2015 and will then be evaluated for its usefulness by the GPSC. Watch for fee details in the MSP Broadcast in mid-December.

Family physicians can bill 14019 for providing advice to a nurse practitioner.  The NP requesting advice has accepted responsibility of being the Most Responsible Provider for a patient’s care in the community. The fee is payable for advice provided over the phone or in person.

The fee is limited to one claim per patient per day, with a maximum of six claims per patient per calendar year. Family physicians may bill 14019 for up to five different patients on any calendar day. A chart entry, including advice given to and to whom, is required.

Notes

  1. Payable for advice by telephone or in person in response to request from a nurse practitioner (NP) in independent practice on patients for whom the NP has accepted the responsibility of being the Most Responsible Provider for that patient’s community care.
  2. Excludes advice to an NP about patients who are attached to the GP.
  3. Payable for advice regarding assessment and management by the NP and without the responding physician seeing the patient.
  4. Not payable for written communication (i.e. fax, letter, e-mail).
  5. A chart entry, including advice given and to whom, is required.
  6. NP Practitioner number required in referring practitioner field.
  7. Not payable for situations where the purpose of the call is to:
    - book an appointment
    - arrange for transfer of care that occurs within 24 hours
    - arrange for an expedited consultation or procedure within 24 hours
    - arrange for laboratory or diagnostic investigations
    - inform the referring physician of results of diagnostic investigations
    - arrange a hospital bed for the patient
  8. Limited to one claim per patient per day with a maximum of 6 claims per patient per calendar year.
  9. Limit of five (5) codes may be billed by a GP on any calendar day.
  10. Not payable in addition to another service on the same day for the same patient by same GP. Out-of-office hours premiums may not be claimed in addition.
  11. Not payable for communications which occur as a part of the performance of routine rounds on the patient if located in a facility.
  12. Not payable to physicians who are employed by or who are under contract to a facility or health authority or who are working under salary, service contract or sessional arrangements and who would otherwise have provided the advice as a requirement of their employment.