A802

PDF page 194 / A66

CONSULTATIONS AND VISITS
VIRTUAL CARE SERVICES
   DEFINITIONS:
    For the purposes of this section of the Schedule only, the following Definitions apply:
     Comprehensive Virtual Care Service means a Virtual Care Service rendered where an
     Existing/Ongoing Patient-Physician Relationship exists, and in the physicians’ professional
     opinion in accordance with accepted professional standards and practice, the person's care
     and support requirements can be effectively and appropriately delivered by Video or
     Telephone.
     Existing/Ongoing Patient-Physician Relationship means:
 1. Where a physician is providing a Virtual Care Service to a patient where there has been at least
    one insured service with a direct physical encounter between the patient and that physician
    (Family and General Practice Physician or specialist) in the preceding 24-months; or
 2. Where a physician is providing a Virtual Care Service to a patient who has signed the MOH’s
    Patient Enrollment and Consent to Release Personal Health Information form and is enrolled to
    that physician or another physician within the same group (who is signatory/locum to a MOH
    alternate funding plan agreement); or
 3. Where a specialist or GP Focused Practice Physician is providing a consultation by Video set
    out in Appendix J – Section 1, or has provided any such consultation in the preceding 24-
    months to that patient; or
     [Commentary:
     Where the visit leading to the referral for consultation has occurred virtually, it would be
     expected that the referring physician has an established relationship with the patient and that
     the clinical issue leading to the referral has been assessed in-person within the previous 12-
     months.]
     [Commentary:
     Where a physician who has been paid for a consultation for the patient for the same diagnosis
     makes a request for a referral for ongoing management of the patient, the service rendered
     following the referral is not payable as a consultation, unless the request for referral, if the
     referral is made, allows for an ongoing patient physician relationship in the context of a
     consultation by Video.]
 4. Where a physician provides any of the following services, or has provided any of the following
    services in the preceding 24-months:
            •   A920 – Medical management of early pregnancy - initial service by Video or
                Telephone,
            •   A945/C945 – Special palliative care consultation by Video,
            •   A320/C320 - Special Medical Assistance in Dying (MAID) consultation by Video,
            •   A680/C680 – Initial assessment - substance abuse by Video,
            •   A814, A817, A818 – Midwife or Aboriginal Midwife-Requested Assessments
                (MRAs) by Video,
            •   A802 – Extended midwife or Aboriginal Midwife-requested genetic assessment by
                Video,

PDF page 240 / A112

Comprehensive midwife or aboriginal midwife-requested genetic assessment
     This service is an assessment provided by a geneticist upon the written request of a midwife or
     aboriginal midwife because of the complex, obscure or serious nature of the patient’s problem.
     This service includes the specific elements of an assessment and the physician must spend a
     minimum of 75 minutes in direct contact with the patient, exclusive of time spent rendering any
     other separately billable intervention to the patient.
 A801 Comprehensive midwife or aboriginal midwife-requested
          genetic assessment............................................................ 342.25
     Payment rules:
     1.This service is limited to one per patient, per physician, per 24 month period.
     2.The geneticist must submit his/her findings, opinions and recommendations in writing to both
       the midwife or aboriginal midwife and the patient’s primary care physician or nurse
       practitioner, if applicable, or the amount payable for the service will be reduced to a lesser
       fee.
     Medical record requirements:
     1.The service is eligible for payment only if start and stop times of the service are recorded in
       the patient's permanent medical record.
     2.The written request from the midwife or aboriginal midwife must be retained on the patient’s
       permanent medical record, or the amount payable for the service will be reduced to a lesser
       fee.
   Extended midwife or aboriginal midwife-requested genetic assessment
     This service is the assessment provided by a geneticist upon the written request of a midwife or
     aboriginal midwife because of the complex, obscure or serious nature of the patient’s problem.
     This service includes the specific elements of an assessment and the physician must spend a
     minimum of 90 minutes in direct contact with the patient, exclusive of time spent rendering any
     other separately billable intervention to the patient.
 A802 Extended midwife or aboriginal midwife-requested genetic
          assessment ........................................................................ 442.40

PDF page 241 / A113

CONSULTATIONS AND VISITS
 GENETICS (22)
          Payment rules:
          1.This service is limited to one per patient, per physician, per 24 month period.
          2.The geneticist must submit his/her findings, opinions and recommendations in writing to both
            the midwife or aboriginal midwife and the patient’s primary care physician or nurse
            practitioner, if applicable, or the amount payable for the service will be reduced to a lesser
            fee.
          Medical record requirements:
          1.The service is eligible for payment only if start and stop times of the service are recorded in
            the patient's permanent medical record.
          2.The written request from the midwife or aboriginal midwife must be retained on the patient’s
            permanent medical record, or the amount payable for the service will be reduced to a lesser
            fee.
          [Commentary:
          Unless otherwise specified in the Schedule, the calculation of time for A801 and A802 excludes
          (1) time devoted to any other service or procedure for which an amount is payable in addition to
          the assessment and (2) non-patient-facing time such as such as time spent reviewing charts,
          imaging, or documentation, etc.]

PDF page 244 / A116

CONSULTATIONS AND VISITS
GENETICS (22)
     EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
      Physician in hospital but not on duty in the Emergency Department when seeing patients in the
      Emergency or OPD - use General Listings.
     NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
      See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
      patients, use General Listings and Premiums when applicable - see General Preamble GP65
      to GP78.
 C225 Consultation* ..........................................................................                    190.50
 C220 Special genetic consultation* - subject to the same conditions
        as A220 ..............................................................................                    342.25
 C223 Extended special genetic consultation* - subject to the same
         conditions as A223 .............................................................                         442.40
 C325 Limited consultation ................................................................                       119.40
 C226 Repeat consultation ................................................................                        119.40
 C800 Midwife or Aboriginal Midwife-requested genetic assessment –
         subject to the same conditions as A800 .............................                                     167.35
 C801 Comprehensive midwife or aboriginal midwife-requested
         genetic assessment – subject to the same conditions as
         A801 ...................................................................................                 342.25
 C802 Extended midwife or aboriginal midwife-requested genetic
         assessment – subject to the same conditions as A802 ......                                               442.40

PDF page 826 / AJ2

APPENDIX J
VIDEO ONLY
     A010A, A011A, A015A, A016A, A021A, A025A, A026A, A035A, A036A,
     A045A, A046A, A050A, A055A, A056A, A065A, A066A, A075A, A076A,
     A085A, A086A, A095A, A096A, A116A, A130A, A135A, A136A, A150A,
     A155A, A156A, A160A, A165A, A166A, A175A, A176A, A180A, A185A,
     A186A, A190A, A191A, A192A, A195A, A196A, A197A, A198A, A205A,
     A206A, A210A, A220A, A223A, A225A, A226A, A235A, A236A, A245A,
     A246A, A253A, A255A, A256A, A260A, A265A, A266A, A275A, A285A,
     A286A, A315A, A316A, A320A, A325A, A335A, A345A, A346A, A355A,
     A356A, A365A, A375A, A385A, A395A, A400A, A405A, A415A, A416A,
     A425A, A435A, A445A, A446A, A460A, A465A, A466A, A470A, A475A,
     A476A, A485A, A486A, A515A, A525A, A545A, A565A, A575A, A580A,
     A586A, A590A, A595A, A600A, A605A, A606A, A615A, A616A, A625A,
     A626A, A635A, A636A, A645A, A646A, A655A, A662A, A665A, A667A,
     A675A, A680A, A682A, A695A, A710A, A715A, A720A, A725A, A726A,
     A735A, A745A, A770A, A775A, A795A, A800A, A801A, A802A, A814A,
     A817A, A818A, A835A, A845A, A865A, A906A, A913A, A914A, A915A,
     A925A, A935A, A945A, C010A, C013A, C014A, C015A, C016A,
     C020A, C023A, C024A, C025A, C026A, C033A, C034A, C035A, C036A,
     C043A, C044A, C045A, C046A, C051A, C053A, C054A, C055A, C063A,
     C064A, C065A, C066A, C071A, C073A, C074A, C075A, C076A, C083A,
     C084A, C085A, C086A, C093A, C094A, C095A, C096A, C111A, C113A,
     C114A, C116A, C130A, C131A, C133A, C134A, C135A, C136A, C150A,
     C151A, C153A, C154A, C155A, C156A, C160A, C161A, C163A, C164A,
     C165A, C166A, C173A, C174A, C175A, C176A, C180A, C181A, C183A,
     C184A, C185A, C186A, C190A, C193A, C194A, C196A, C203A, C204A,
     C205A, C206A, C210A, C220A, C223A, C225A, C226A, C233A, C234A,
     C235A, C236A, C243A, C244A, C245A, C246A, C255A, C260A, C263A,
     C264A, C265A, C266A, C270A, C275A, C283A, C285A, C286A, C311A,
     C313A, C314A, C315A, C316A, C320A, C325A, C335A, C341A, C343A,
     C344A, C345A, C346A, C353A, C354A, C355A, C356A, C365A, C375A,
     C385A, C395A, C411A, C413A, C414A, C415A, C416A, C425A, C435A,
     C441A, C443A, C444A, C445A, C446A, C460A, C461A, C463A, C464A,
     C465A, C466A, C470A, C471A, C473A, C474A, C475A, C476A, C480A,
     C481A, C483A, C484A, C485A, C486A, C510A, C511A, C515A, C545A,
     C565A, C570A, C575A, C580A, C585A, C586A, C590A, C595A, C600A,
     C601A, C603A, C604A, C605A, C606A, C611A, C613A, C614A, C615A,
     C616A, C623A, C624A, C625A, C626A, C635A, C643A, C644A, C645A,
     C646A, C655A, C661A, C662A, C665A, C667A, C675A, C680A, C682A,
     C695A, C720A, C721A, C723A, C724A, C725A, C726A, C710A, C713A,
     C715A, C735A, C745A, C760A, C770A, C775A, C795A, C845A, C865A,
     C895A, C915A, C925A, C935A, C945A, K630A, W025A, W026A,
     W075A, W076A, W130A, W150A, W155A, W156A, W165A, W185A,
     W190A, W196A, W235A, W236A, W275A, W310A, W355A, W356A,
     W375A, W395A, W425A, W435A, W465A, W466A, W510A, W511A,
     W515A, W516A, W535A, W720A, W725A, W726A, W770A, W775A,
     W795A, W895A, W925A

Master, record 298. Record Layout PDF, page 1.

A80220260401999999990000000000000000000000000044240000000000000000000000000

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.