Business Cost Premium

The Business Cost Premium (BCP) is a payment originally negotiated in the 2019 Physician Master Agreement (PMA) to help eligible physicians cover the rising rent, lease, or ownership costs of a community-based office. The BCP is a percentage premium currently paid on MSP fees for Consultation, Visit, Counselling, and Complete Examination services, when provided in-person or by Telehealth in a community-based office in an eligible geographical location. The 2022 PMA outlines changes to expand access to the BCP.

2022 BCP Expansion

Status: Implementation Delayed

March 13, 2024, UPDATE: Due to implementation challenges faced by Health Insurance BC (HIBC), the administrator of MSP payments, the 2022 BCP expansion continues to be delayed.

What this means: Physicians cannot yet claim the BCP on MSP services provided in a hospital setting, or on MSP fees beyond Consultation, Visit, Counselling, and Complete Examinations. The only BCP payments that are currently being processed are under the original 2019 PMA guidelines.

2023/24 Retroactive Payment

The final BCP retroactive payments for the 2023/24 fiscal year, which includes physicians registered under the expanded eligibility criteria, will be disbursed by Health Insurance BC (HIBC) on December 15, 2024. Payments on claims for dates of service between April 1, 2023, and March 30, 2024, will appear on eligible physician’s remittance statements under adjustment code BQ. Payments will vary between eligible physicians and be lower for physicians who have already received some, or all, BCP under the original 2019 PMA guidelines.

For all physicians who are eligible under the expanded criteria and have completed the BCP registration process, the final retroactive payment was manually calculated for all services provided by the physician regardless of the location at which the service was delivered. For physicians who did not include a BCP facility number on their billing claims, which identifies the physical location and determines the correct percentage premium, the calculations were based on the location each physician is attached to with the highest BCP percentage value and daily maximum amount, which vary by eligible location.

2022 BCP Expansion – Guidelines and Eligibility

The 2022 PMA expands the BCP to apply to fees for all services provided by physicians regardless of the healthcare setting where the services are delivered, subject to the following conditions:

Although the eligible healthcare settings will be expanded to include locations such as hospitals, the physician must still be responsible for some or all of the rent, lease, or ownership costs of a community-based office (either directly or indirectly) in an eligible geographical location, where they see patients in person. Physicians must complete a Practitioner Attachment form to attach themselves to an eligible community-based office (scroll down for Registration info and applications).
Eligible geographical locations include Vancouver, Victoria, Greater Vancouver, Greater Victoria, and other communities not receiving RRP.
Physicians receiving Rural Retention Program (RRP) benefits are not eligible for the BCP. This criterion continues under the new rules: physicians receiving RRP will not be eligible to receive BCP for services provided in a hospital, regardless of whether the hospital is in an eligible geographical location. RRP physicians may be eligible to receive the Rural Business Cost Modifier (RCBM) premium for their office in the rural community where they receive RRP. The BCP cannot be applied to billings for services provided in a hospital when the physician does not contribute to rent, lease, or ownership costs of a community-based office in an eligible geographical location. Information on the RBCM can be found here.
Physician is entitled to receive and retain payment for the eligible fees directly from MSP (e.g. payments assigned to Health Authorities are not eligible for the premium).
Physician is compensated by fee-for-service. The BCP does not apply to physicians compensated by Alternative Payment Programs (APP) or the Longitudinal Family Payment (LFP) model.
The BCP will not apply to radiology, anesthesiology, pathology and nuclear medicine fees for services delivered in or for Agency facilities.
Full details of the expected changes can be found in APPENDIX F, section 1.7 Business Cost Premium of the 2022 Physician Master Agreement.

Preparing for the changes

Although the changes are not yet effective, physicians are encouraged to prepare for the expansion by completing the following steps:

Complete a BCP Facility Number application for your community-based office, and
Complete a Physician Attachment form. This step is crucial, as although the BCP facility number will be used as an identifier on the billing claim, HIBC will check to confirm that the physician is attached to a community-based office in an eligible geographical location.

See “Registering for the BCP” below for application forms and instructions.

Consult with your EMR vendor to ensure that the BCP facility number and applicable Service Location Code (SLC) can be entered on all MSP claims.
If you are currently receiving BCP, confirm with your vendor that the BCP facility number and applicable SLC can be entered on all MSP claims beyond Consultation, Visit, Counselling, and Complete Examinations.
Billing claim requirements (when implemented):
- BCP Facility codes and Service Location Codes (SLCs) are mandatory requirements for payment of the BCP. Both BCP Facility Code and SLC data fields must be populated on each MSP billing claim.
- As BCP facility codes are currently limited to community offices, work is underway to expand facility codes to include all locations where physicians are entitled to receive and retain payment for fees directly from MSP.

How is the BCP calculated and paid to physicians?

The percentage values and the daily maximum amounts of the BCP are based on the eligible fees and the location of the community-based office in which the services are provided:

City of Vancouver: 5% of eligible fees up to a maximum BCP payment of $60 per day per physician.
Metro Vancouver (excluding the City of Vancouver) and Greater Victoria: 4% of eligible fees up to a maximum BCP payment of $48 per day per physician.
Other communities (outside Greater Vancouver and Greater Victoria) not eligible for the Rural Retention Premiums: 3% of eligible fees up to a maximum BCP payment of $36 per day per physician.

The BCP will be applied to eligible fees submitted on physician’s MSP-billing claims, and will be paid to the physician’s payee number (or assigned payee number, if applicable). The claims system will apply the percentage for the premium and calculate the daily maximum. In order to identify the physical location in which services are provided and for the correct percentage premium to be applied, physicians will need to include their assigned BCP Facility Number on their billing claims.

List of eligible fees by section.

See BCP payment FAQs

Registering for the BCP

Health Insurance BC (HIBC) administers the BCP and processes the applications on behalf of MSP. For technical support, including application submission, and registration confirmation, please contact HIBC at the phone numbers listed below:

Vancouver: 604 456 6950
Elsewhere in BC: 1 866 456 6950

Registering for the BCP involves two steps: 1) Obtain a BCP Facility Number, and 2) complete a Physician Attachment form.

Step 1

Register your community-based office for a BCP Facility Number, which will identify the physical location in which services are provided and allow for the correct percentage premium to be applied.

The physician responsible for administration of the office (the “Facility Administrator”) can apply for a BCP Facility Number by submitting the online application linked below. Only one BCP Facility Number is required per office, regardless if it is a solo or group practice.

Obtain BCP Facility Number forms:

Online Application
Fill and print form

Notes:

Only the Facility Administrator should apply for a BCP Facility Number, to ensure multiple applications for the same location are not submitted.
If you are the Facility Administrator at multiple eligible locations, a BCP Facility Number application will need to be submitted for each unique physical location.
Ensure to check the box to request the BCP be applied to eligible fees paid to eligible physicians attached to that facility.
The facility effective date is the date the clinic originally opened at its current location.
If you prefer to mail the application, complete the “Fill and Print” form and mail to the Health Insurance BC address listed at the bottom of the form.

Step 2

Once your location has been assigned a BCP Facility Number you can complete the online Physician Attachment form linked below to attach yourself to your office and its Facility Number.

Practitioner Attachment forms:

Online application
Fill and print form

Notes:

If you practice at multiple eligible offices, please complete a Practitioner Attachment form for each unique location.
If you prefer to mail the application, complete the “Fill and Print” form and mail to the Health Insurance BC address listed at the bottom of the form.

See Registration FAQs

Cancel or change details for a facility

If there are any changes to the information after the BCP Facility Number application form has been submitted, the Facility Administrator must submit the “Application to Cancel or Change Details for Facilities with an MSP Facility Number” form linked below.

Online application
Fill and print form

FAQ’s

Eligibility: Who or what is eligible for BCP?

Are the two new temporary fee codes for COVID-19 eligible for the BCP?: Yes, fee codes T13701 (Office Visit for COVID-19 with test) and T13702 (Office Visit for COVID-19 without test) are both eligible for the BCP, as Visits are considered an eligible service under the BCP criteria.
If I receive Rural Retention Premiums (RRP), do I qualify for the BCP?: No, eligible locations include the city of Vancouver, Metro Vancouver, the greater Victoria area, and other communities not eligible for the RRP. There are other mechanisms in-place for funding in rural locations.
What qualifies as ownership costs?: Examples of ownership costs include mortgage, utilities, property taxes, etc.
Are walk-in clinics eligible?: Yes, if the walk-in clinic is located in an eligible geographical location, and you are an eligible physician paying towards the lease, rent or ownership costs of the clinic.
There are multiple physicians working in a group clinic, with some paying towards business expenses and others who are not. How does that work?: Only the physicians who pay towards the rent, lease, or ownership costs of an eligible office would qualify for the BCP.
I work in a clinic but do not own it, do I qualify?: Yes, if it is an eligible clinic and you pay towards the lease, rent, or ownership costs.

Information for locums

I am working as a locum, do I qualify?: Yes, if you work in a clinic that qualifies and part of your agreement is to cover some of the lease, rent, or ownership costs. The payment will be paid to the Payee number you have assigned on the Assignment of Payment form. The payment should be distributed between the host physician/clinic and locum as per your agreement.
If I provide locum services in two different clinics on the same day, how will the BCP be paid?: The BCP may be paid on multiple facility numbers. The BCP daily maximum though is based on an individual practitioner. The BCP will paid to a practitioner maximum on whichever eligible claims are received first, regardless of facility or payee number. If the maximum is reached on the first clinics claims, then no BCP is paid to the second clinic. However, if the maximum is not reached for the first clinic, the remaining amount will be paid to the second clinic.

Many locums complete an Assignment of Payment (AOP) form with a 1-year time range so that they don’t need to complete a new AOP each time they provide locum services at that clinic. Are precise dates required for the BCP form, or can locums do the same without impact on billings?: No, precise dates are not needed for locums, they can put in the same dates as their AOP. If circumstances change and the physician cancels their AOP, they should update their registration on the APPLICATION TO CANCEL OR CHANGE DETAILS FOR FACILITIES WITH AN MSP FACILITY NUMBER form.
When working as a locum, can I apply online for the BCP and Assignment of Payment at the same time?: Not at this time. These are two separate forms. Practitioner attachment for the BCP can be completed online using a new electronic form, while the existing Assignment of Payment form must be submitted by Canada Post or fax.

Registration: Application questions

Can I still register for the BCP after April 1, 2020?

Yes. If your registration isn’t complete until after April 1, you have two options to claim the BCP:

Hold your billing claims from April 1 onwards. Once your BCP registration has been completed (e.g. you have been assigned a facility number and completed the Practitioner Attachment process), submit your claims and the BCP will be applied to the eligible fees.
Continue submitting your billing claims as you typically would, and once your BCP registration has been completed you can resubmit your claims from April 1 onwards to claim the BCP on eligible fees.

I received an error message saying the information on my application does not match MSP records. What does this mean?

This most likely means you have entered your Payee number in the MSP Practitioner Number field instead of your personal MSP Practitioner number.

The Application For MSP Facility Number asks for the Facility Effective Date. What is this?

This is the date the clinic/office originally opened at its current location. If you don’t know this date, please use April 1, 2020.

Who do I call if I experience technical difficulties with an application form?

You can call the HIBC Practitioner number for technical assistance with a form:

Vancouver: (604) 456-6950

Elsewhere in BC: 1-866-456-6950

What if I practice at more than one office?

If you practice at more than one eligible office (e.g. two offices) and pay towards the lease, rent, or ownership costs at both places, then you would be eligible for the BCP whenever you provide eligible services at either location. You must complete the Practitioner attachment for each unique eligible office.

What if no longer work at an office where I am attached to a BCP Facility Number?

To change physician attachment details, the Facility Administrator must submit the “Application to Cancel or Change Details for Facilities with an MSP Facility Number” form to HIBC: https://my.gov.bc.ca/bcp/update-facility/home

Premium: How will the BCP be paid?

Where will my payment notification show up?

It will show up as a Level 1 adjustment on your remittance statement.

Can facility owners retain all of the BCP?

The BCP is an MSP payment and the sharing between physicians and clinic owners should be based on your current agreement regarding overhead costs, unless you agree to an alternative arrangement. The PMA clearly states that the BCP is for physicians, and therefore clinic owners cannot automatically retain all of the BCP.

Is the daily maximum per physician per location?

No, the daily maximum is per physician per day across all locations or facilities.

How do I claim retroactive BCP payment?

Billing claims should be resubmitted with the exact same details, but this time add the BCP Facility Number that was assigned to your office. The claims system will automatically debit off the original claim and process your resubmitted claim, and apply the BCP to applicable fees. For claims greater than 90 days, submission code A is required. The form can be found here.

Doctors who register by July 31, 2022 are eligible to resubmit billing claims to receive retroactive BCP payment back to April 1, 2021.

Doctors who register on August 1, 2022 or after are eligible to resubmit billing claims to receive retroactive BCP payment back to April 1, 2022.

Online BCP webinar: Recording from March 12, 2020

Business Cost Premium Education Webinar March 12, 2020 recording

Details covered in the session included eligibility criteria, how to register for a facility number, and EMR requirements for submitting BCP claims.

Resources for support:

Health Insurance BC (HIBC) administers the BCP and processes the applications on behalf of MSP. For technical support, including application submission, and registration confirmation, please contact HIBC at the phone numbers listed below. HIBC has dedicated support for the BCP, so please follow the prompts for the “Business Cost Premium” when phoning.

Vancouver: 604 456 6950

Elsewhere in BC: 1 866 456 6950

If your question isn’t covered in the FAQ’s, the Doctors of BC Economics team can be reached at economics@doctorsofbc.ca

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