A physician enrolled in the LFP Payment Model may bill for respiratory immunizations provided by Allied Care Providers from October 1, 2023 to March 31, 2024 using the temporary code 98101 LFP Respiratory Immunization Provided by an Allied Care Provider.
In order to bill this code, the Allied Care Provider must be paid out of practice earnings to work directly within the practice team with no cost recovery either directly or indirectly from a third party (e.g. Health Authority, Division of Family Practice, Ministry of Health).
“Allied Care Provider” means a College-certified trained professional who is governed by a provincial regulatory college and has a scope of practice that allows provision of medical and medically related services to patients. Examples include but are not limited to nurses, nurse practitioners, midwives, pharmacists etc.
Only four types of immunizations can be billed: influenza, pneumococcal, pertussis, and COVID-19.
98101 LFP Respiratory Immunization Provided by an Allied Care Provider…………………….……..$14
Notes:
a) Payable only to physicians who have billed 98000 Registration Code and locum physicians who have billed 98005 Locum Registration Code.
b) Payable for influenza (using ICD-9 code V048), pneumococcal (using ICD 9 code V05), pertussis (using ICD-9 code V036), and COVID-19 (using ICD-9 code C19) immunizations.
c) Payable only when the immunization is provided by an Allied Care Provider who is employed by a physician practice. The Allied Care Provider must be paid out of practice earnings to work directly within the practice team with no cost recovery either directly or indirectly from a third party (e.g. Health Authority, Division of Family Practice, Ministry of Health).
d) Payable for a maximum of three immunizations per patient per day
e) Payable only for immunizations provided from October 1, 2023 to March 31, 2024.
f) This code is not subject to the daily maximum of 50 Patient Interaction Codes and Locum Patient Interaction Codes.
g) This code is not subject to the 30% limit on Non-Panel Services