New temporary fee codes for COVID-19 immunizations

OCTOBER 2023 DISCLAIMER: Please note that the below fee codes were deleted in 2023 per the Public Health Officer, and are no longer billable.

To support the anticipated arrival of new fridge-stable COVID-19 vaccines that can be administered in a range of different locations, three temporary COVID-19 immunization fees have been approved. Developed in collaboration with BC Family Doctors, the three fees will be billable by both family physicians and specialists. The temporary fees are effective immediately and the end date for all three fees will be determined by the Provincial Health Officer.

The COVID-19 immunization fees T10042 - with visit and TB10043 - without visit are based on the two temporary respiratory immunization fees approved in the fall. In most circumstances, the steps involved in providing these COVID-19 immunizations is expected to be similar to that of providing a flu or pneumococcal immunization. While these immunizations are largely accepted and understood by patients the COVID-19 immunization may not be as easily administered.

Doctors may need to spend more time with some patients, whether that is time spent directly addressing vaccine hesitancy, generally educating patients, or managing unique patient needs. In these situations, if the total time the physician spends with the patient exceeds 10 minutes, physicians may bill a third extended COVID-19 immunization fee (TB10044) in addition to the stand alone immunization fee (TB10043). This provides total remuneration equal to the lowest office visit fee of $31.62.

Details of the new fees:

T10042 COVID-19 immunization (with visit) ………. 5.43

Notes:

i) Payable for COVID-19 immunization (ICD-9 code C19 must be entered on claim).

ii) Payable in full with a visit.

iii) If the primary purpose of the service is for immunization, bill fee item TB10043 and TB10044 if applicable.

TB10043 COVID-19 immunization (without visit) ……….14.00

Notes:

i) Payable for COVID-19 immunization (ICD-9 code C19 must be entered on claim).

ii) Not payable with a visit.

TB10044 Extended COVID-19 immunization (extra)………17.62

Notes:

i) Payable for an extended COVID-19 immunization (ICD-9 code C19 must be entered on claim).

ii) Paid only in addition to 10043 where physician time with the patient exceeds 10 minutes.

iii) Start and end times must be entered in both the billing claim and the patient's chart.

iv) Not payable for immunizations provided as part of a health authority immunization program.

v) Cannot be delegated to a nurse or other employee of the physician's practice.