A006

PDF page 131 / A3

CONSULTATIONS AND VISITS
 FAMILY PRACTICE & PRACTICE IN GENERAL (00)
          Payment rules:
          1.This service is claimed in units. Unit means ½ hour or major part thereof - see General
            Preamble GP7, GP55 for definitions and time-keeping requirements. Start and stop times
            must be recorded in the patient's permanent medical record. Minimum time requirements can
            be consecutive or non-consecutive time on the same day.
          2.When the duration of A320 or C320 exceeds 50 minutes, one or more units of K321 are
            payable in addition to A320 or C320, provided that the minimum time requirements for K321
            units occurs 50 minutes after the start time for A320 or C320.
          3.K321 is payable to a maximum of two physicians, same patient same day.
          4.With the exception of A320/C320, no other insured services or premiums are eligible for
            payment during the same period of time when MAID support is claimed.
          5.K321 is payable in circumstances where the patient is found to be ineligible for MAID on the
            day of planned MAID intervention or where the patient does not provide consent for MAID
            intervention.
          Claims submission instructions:
          Claims in excess of 12 units by the same physician for the same patient should be submitted
          using the manual review indicator and accompanied by supporting documentation.
          [Commentary:
          1.The CPSO has established guidance, which lay out a number of safeguards for the provision
            of MAID in Ontario. For further information related to the provision of MAID in Ontario,
            physicians should refer to the CPSO’s website (http://www.cpso.on.ca/).]
   A905 Limited consultation ................................................................   80.15
   A006 Repeat consultation ................................................................    47.10

PDF page 184 / A56

CONSULTATIONS AND VISITS
FAMILY PRACTICE & PRACTICE IN GENERAL (00)
   Initial discussion with patient re: smoking cessation
     Initial discussion with patient re: smoking cessation is the service rendered to a patient who
     currently smokes tobacco by the primary care physician most responsible for their patient’s
     ongoing care, in accordance with the guidelines and subject to the conditions below.
 E079 Initial discussion with patient, to eligible services ............. add         15.95
     Payment rules:
     1.E079 is only eligible for payment when rendered in conjunction with one of the following
        services: A001, A003, A004, A005, A006, A007, A008, A905, K005, K007, K013, K017,
        K130, K131, K132, K133, P003, P004, P005, P008, W001, W002, W003, W004, W008,
        W010, W102, W104, W107, W109 or W121.
     2.E079 is limited to a maximum of one service per patient per 12 month period.
     Medical record requirements:
     The medical record for this service must document that an initial smoking cessation discussion
     has taken place, by either completion of a flow sheet or other documentation consistent with
     the most current guidelines of the “Clinical Tobacco Intervention” (CTI) program, or the service
     is not eligible for payment.
     [Commentary:
     1.Physicians may complete a flow sheet or alternatively document that an initial discussion
       consistent with the 5A's model of the CTI program has taken place.
     2.E079 is not eligible for payment for discussions related to cannabis smoking or discussions
       related to vaping, including vaping tobacco.]
   Smoking cessation follow-up visit
     Smoking cessation follow-up visit is the service rendered by a primary care physician in the 12
     months following E079 that is dedicated to a discussion of tobacco smoking cessation, in
     accordance with the guidelines and subject to the conditions below.
 K039 Smoking cessation follow-up visit ........................................... 39.25
     Payment rules:
     1.K039 is only eligible for payment when E079 is payable to the same physician in the
       preceding 12 month period.
     2.K039 is limited to a maximum of two services in the 12 months following E079.
     Medical record requirements:
     The medical record for this service must document that a follow-up visit regarding smoking
     cessation has taken place, by either completion of a flow sheet or other documentation
     consistent with the most current guidelines of the “Clinical Tobacco Intervention” (CTI)
     program, or the service is not eligible for payment.
     [Commentary:
     1.Physicians may complete a flow sheet or alternatively document that an initial discussion
       consistent with the 5A's model of the CTI program has taken place.
     2.K039 is not eligible for payment for discussions related to cannabis smoking or discussions
       related to vaping, including vaping tobacco.]

Master, record 6. Record Layout PDF, page 1.

A00620260401999999990000047100000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.