Update: New Hospital at Home fees

The BC Government, as part of its COVID-19 Go-Forward Management Strategy, is proceeding with the implementation of its Hospital at Home (HaH) program across BC over the next few months. 

Hospital at Home provides acute care services to patients in their own home. It allows eligible patients requiring hospital care to be “admitted” to hospital, but to receive that care at home from an interdisciplinary team led by a most responsible practitioner (MRP) with hospital admitting privileges.

Hospital at Home is intended to provide care that is equivalent to care provided within a hospital. 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.

Innovation from the ground up: Learn how two Victoria hospitalists played a key role in developing the Hospital at Home program recently launched in BC. 

Fee Details

P13011 Hospital at Home visit ................................................................$64.64

Notes:

i) Payable only for patients admitted for care under the Hospital at Home

program.

ii) 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).

iii) 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 13011. The claim must include the time of each visit and a

statement of need included a note record.

iv) 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.

v) 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:

i) Payable only for patients admitted for care under the Hospital at Home

program.

ii) 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.

iii) Conferencing cannot be delegated. No claim may be made where

communication is with a proxy for either provider.

iv) Details of care conference must be documented in the patient’s chart as well

as information on clinical discussion and decisions made.

v) 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:

a. Book an appointment

b. Arrange for an expedited consultation or procedure

c. Arrange for laboratory or diagnostic investigations

d. Convey the results of diagnostic investigations

e. Arrange a hospital bed for a patient.

vi) 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).

vii) Payable to a maximum of 2 units (30 minutes) per patient on any single day.

viii) If multiple patients are discussed, the billings must be for consecutive,

non-overlapping time periods.

ix) 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.

x) Not payable in addition to PG14018 or PG14077 on same day to same

physician for the same patient.

xi) Not payable to physicians working under an Alternative Payment/Funding

model whose duties would otherwise include provision of this service.