The Hospital at Home program is being implemented in communities across BC over the next few months, starting with Victoria and Prince George.
Hospital at Home is designed to provide acute care services to patients in their own home. It allows eligible patients requiring hospital-level care to be “admitted” to hospital, but to receive that care at home from an interdisciplinary team led by a physician with hospital admitting privileges. It will allow a subset of acutely ill patients to choose an alternative to traditional inpatient treatment when appropriate and desired by both the patient and physician.
Effective November 1, 2020, two new fees will be available to bill for Hospital at Home services: a Hospital at Home visit fee and a Hospital at Home FP Conference with Allied Care Provider and/or Physician.
P13011 Hospital at Home visit ……………………………………………………….$64.64
Notes:
- Payable only for patients admitted for care under the Hospital at Home program.
- Additional visits are not payable on same day to same physician for the same patient, except as set out in the notes iii) and iv).
- Essential non-emergent additional visits to a hospitalized patient by the attending or replacement physician during one day are to be billed under fee item 13XX2. The claim must include the time of each visit and a statement of need included a note record.
- For weekday daytime emergency visit, see fee item 00112. Fee items 12200, 13200, 15200, 16200, 17200, 18200 may be billed for additional evening, night time, or weekend emergent hospital visits same day, same patient when the attending physician or replacement physician is specially called back as the patient’s condition has changed, requiring the physician’s attendance or due to a condition unrelated to the hospitalization. The claim must include the time of service and an explanation for the visit included in the note record.
- Call-out charges apply under fee items 01200, 01201, 01202 only when the physician is specially called to render emergency or non-elective services and only when the physician must travel from one location to another to attend the patient and may include continuing care fee charges 01205, 01206, 01207 if applicable.
P13012 Hospital at Home FP Conference with Allied Care Provider and/or Physician –
per 15 minutes or greater portion thereof …………………………………………………. $43.23
Notes:
- Payable only for patients admitted for care under the Hospital at Home program.
- Payable for two-way collaborative conferencing, either by telephone, videoconferencing or in-person, between the Family Physician and an allied care provider and/or a physician.
- Conferencing cannot be delegated. No claim may be made where communication is with a proxy for either provider.
- Details of care conference must be documented in the patient’s chart as well as information on clinical discussion and decisions made.
- Not payable for simple advice to a non-physician allied care provider about the patient or where the primary purpose of the call is to:
- Book an appointment
- Arrange for an expedited consultation or procedure
- Arrange for laboratory or diagnostic investigations
- Convey the results of diagnostic investigations
- Arrange a hospital bed for a patient.
- Payable in addition to any visit fee on the same day if medically required and does not take place during a time interval that overlaps with the patient conference (i.e. Visit time is separate from conference time).
- Payable to a maximum of 2 units (30 minutes) per patient on any single day.
- If multiple patients are discussed, the billings must be for consecutive, non-overlapping time periods.
- Start and end times must be included with the claim and documented in the patient chart. If conferencing takes place as a series of separate phone calls, use the start time of the first call and calculate the “end time” based on total time spent conferencing.
- Not payable in addition to PG14018 or PG14077 on same day to same physician for the same patient.
- Not payable to physicians working under an Alternative Payment/Funding model whose duties would otherwise include provision of this service.