K023

PDF page 42 / GP28

FIRST VISIT BY PRIMARY CARE PHYSICIAN AFTER HOSPITAL DISCHARGE
  E080 First visit after hospital discharge premium, to other service
          listed in payment rule 5 below ..................................... add        25.90
      Payment rules:
      1.Subject to payment rules 2 through 5, E080 is only eligible for payment for a visit with the
        patient's primary care physician in the physician’s office or the patient’s home within two
        weeks of discharge following in-patient admission to an acute care hospital.
      [Commentary:
      This premium is not payable for visits rendered to patients in locations other than the
      physician's office or patient's home. As such, the premium is not payable for services rendered
      in places such as Nursing Homes, Homes for the Aged, chronic care hospitals, etc.]
      2.E080 is not eligible for payment if the admission to hospital was for the purpose of obstetrical
        delivery unless the mother required admission to an ICU during the hospital stay.
      3.E080 is not eligible for payment if the admission to hospital was for the purpose of newborn
        care unless the infant required admission to a NICU during the hospital stay.
      4.E080 is not eligible for payment if the admission to hospital was for the purpose of performing
        day surgery.
      5.E080 is only eligible for payment when rendered with the following services:
        A001, A003, A004, A007, A008, A261, A262, A263, A264, A888, A900, K004–K008, K013,
        K014, K022, K023, K028-K030, K032, K033, K037, K623, P003, P004, P008.

PDF page 129 / A1

Consultations and VisitsJ uly 22, 2026 (effective July 1, 2026)
                                                                  CONSULTATIONS AND VISITS
      FAMILY PRACTICE & PRACTICE IN GENERAL (00)
                 GENERAL LISTINGS
               A005 Consultation............................................................................               95.60
                 Special family and general practice consultation
                   This service is a consultation rendered by a GP/FP physician who provides all the elements of
                   a consultation and spends a minimum of 50 minutes in direct contact with the patient, exclusive
                   of time spent rendering any other separately billable intervention to the patient.
               A911 Special family and general practice consultation....................            164.95
                 Comprehensive family and general practice consultation
                   This service is a consultation rendered by a GP/FP physician who provides all the elements of
                   a consultation and spends a minimum of 75 minutes in direct contact with the patient, exclusive
                   of time spent rendering any other separately billable intervention to the patient.
               A912 Comprehensive family and general practice consultation ......                   247.40
                   Payment rules:
                   1.For A911 and A912, the start and stop times must be recorded in the patient’s permanent
                     medical record or the amount payable for the service will be adjusted to a lesser paying fee.
                                            2.No other consultation, assessment, visit or counselling service is eligible for payment when
                                              rendered the same day as one of A911 or A912 to the same patient by the same physician.
                                            [Commentary:
                                            1.A911 and A912 must satisfy all the elements of a consultation (see page GP16).
                                            2.Unless otherwise specified in the Schedule, the calculation of the 50 minute and 75 minute
                                              minimum for special and comprehensive consultations respectively excludes (1) time
                                              devoted to any other service or procedure for which an amount is payable in addition to the
                                              consultation and (2) non-patient-facing time such as such as time spent reviewing charts,
                                              imaging, or documentation, etc.]
                 Special palliative care consultation
                   A special palliative care consultation is a consultation requested because of the need for
                   specialized management for palliative care where the physician spends a minimum of 50
                   minutes in direct contact with the patient and/or patient's representative/family in consultation
                   (majority of time must be spent in consultation with the patient) exclusive of time spent
                   rendering any other separately billable intervention to the patient. In addition to the general
                   requirements for a consultation, the service includes a psychosocial assessment,
                   comprehensive review of pharmacotherapy, appropriate counselling and consideration of
                   appropriate community services, where indicated.
               A945 Special palliative care consultation.........................................    174.25
                   Payment rules:
                   1.Start and stop times must be recorded in the patient’s permanent medical record or the
                     amount payable for the service will be adjusted to a lesser paying fee.
                                            2.When the duration of a palliative care consultation (A945 or C945) exceeds 50 minutes, one
                                              or more units of K023 are payable in addition to A945 or C945, provided that the minimum
                                              time requirements for K023 are met. The time periods for A945 or C945 and K023 are
                                              mutually exclusive (i.e. the start time for determination of minimum time requirements for
                                              K023 occurs 50 minutes after start time for A945 or C945).

PDF page 130 / A2

Palliative care support
     Palliative care support is a time-based service payable for providing pain and symptom
     management, emotional support and counselling to patients receiving palliative care.
 K023 Palliative care support .................................................per unit 85.25

PDF page 130 / A2

Payment rules:
     1.With the exception of A945/C945, any other services listed under the "Family Practice &
       Practice in General" in the "Consultations and Visits" section of the Schedule are not eligible
       for payment when rendered with this service.
     2.Start and stop times must be recorded in the patient's permanent medical record or the
       service will be adjusted to a lesser paying fee.
     3.When the duration of A945 or C945 exceeds 50 minutes, one or more units of K023 are
       payable in addition to A945 or C945, provided that the minimum time requirements for K023
       units occurs 50 minutes after the start time for A945 or C945.
     4.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.
   Special Medical Assistance in Dying consultation
     A special Medical Assistance in Dying (MAID) consultation is a consultation conducted for the
     purpose of assessing the eligibility for MAID in a patient who has submitted a written request
     for MAID. This service is a consultation rendered by a physician who provides all the elements
     of a consultation and spends a minimum of fifty (50) minutes of direct contact with the patient
     exclusive of time spent rendering any other separately billable intervention to the patient. A320
     includes the preparation and transmission of all necessary documentation.
 A320 Special Medical Assistance in Dying (MAID) consultation ......                  174.25
     Payment rules:
     1.Start and stop times must be recorded in the patient’s permanent medical record.
     2.When the duration of a special MAID consultation (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 are met. The time periods for A320 or C320 and K321 are
       mutually exclusive (i.e. the start time for determination of minimum time requirements for
       K321 occurs 50 minutes after start time for A320 or C320).
   Medical Assistance in Dying support
     Medical Assistance in Dying (MAID) support is a time-based service payable for providing
     MAID assessment, support and counselling to patients requesting MAID, and provision of
     MAID by a physician. MAID support is only eligible for payment when rendered personally by
     the physician.
 K321 Medical Assistance in Dying (MAID) support...............per unit           85.25

PDF page 516 / J102

[Commentary:
       1.Services not excluded in payment rule #2 such as assessments, subsequent visit fees,
         W010, K023, special visit premiums etc. remain eligible for payment when rendered with
         G512.
       2.See the Definitions section of the General Preamble for the definition of palliative care
       3.This service is eligible for payment for services rendered to patients receiving palliative care
         in any location including their home, hospital, nursing home etc.]

Master, record 2901. Record Layout PDF, page 1.

K02320260401999999990000085250000000000000000000000000000000000000000000000

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.