You told us that you were worried about how you would provide flu shots during the pandemic. We heard you.
We have been advocating for appropriate remuneration for flu shots to address the increased costs of providing immunizations due to COVID-19.
We are pleased to announce that we were successful in securing an add-on fee for influenza and pneumococcal immunizations. We are continuing discussions with the Medical Services Plan regarding stand-alone immunizations.
For dates of service on or after Oct 1, 2020, a new temporary fee code for adult respiratory immunizations (influenza and pneumococcal) will be effective. This will allow physicians to bill for these immunizations in addition to an in-person visit for an unrelated reason (office visit, prenatal visit, counselling, consultation etc) done.
T10040 Respiratory immunization for patients 19 years of age or older ………………………………………..$5.43
i) Payable for Influenza (using ICD-9 code V048) and Pneumococcal (using ICD-9 code V05) immunizations.
ii) Payable in full with an office visit.
iii) If the primary purpose of the visit is for immunization, bill fee item 00010 using ICD-9 code V048 for influenza and/or V05 for pneumococcal.
This new fee will provide the opportunity for you to address your patients’ health concerns at the same time that you provide immunization.
The end date of the temporary fee will be determined by the Provincial Health Officer.
Pediatric Flu Shots
In children, immunizations are billable in addition to a visit. For patients under the age of 19 years of age, bill under fee item 10015zzyy plus the applicable office visit for influenza immunization. The other childhood immunization codes are listed here.