September 9, 2024

New LFP Payment Schedule

Doctors of BC and BC Family Doctors continue to work with the Ministry of Health to refine and improve the Longitudinal Family Physician (LFP) Payment Model. We continue to listen to your feedback and adjust the payment model to address your concerns. To submit questions or feedback, please email FP.Billing@doctorsofbc.ca.

In this newsletter, we are providing information on the following:

Updated LFP Payment Schedule
Billing for respiratory immunizations
LFP Panel Payment reminder
Billing tips

Updated LFP Payment Schedule - effective September 6, 2024

The new LFP Payment Schedule (effective September 6, 2024) includes an updated process for physicians who need an exception to the 30% limit of Clinic Non-panel Services.

We recommend reviewing the updated LFP Payment Schedule in its entirety to ensure that you are billing accurately. BC Family Doctors’ web resources, including the Simplified LFP Guide and Billing Question Library, are being updated to reflect all of the changes in the payment schedule.

New process for physicians exceeding the 30% limit on Clinic Non-panel Services

All family physicians enrolled in the LFP Payment Model must meet the eligibility requirements of the LFP Payment Schedule. This includes the requirement that a physician must ensure that Clinic Non-panel Services are no more than 30% of LFP Clinic-based Services.

Physicians do not need to meet this requirement until March 31, 2025, if they are actively transitioning their practice to meet this requirement and submit:

98001 LFP Clinic-based Services Transition Code on or after September 1, 2024; and
An LFP Clinic-based Services Transition Form on or after September 1, 2024.

The following physicians are not required to submit the Clinic-based Services Transition Code and Transition Form:

Physicians providing only locum services
Physicians practicing in rural communities that were receiving Northern Isolation Allowance (NIA) premiums as of December 15, 2002.

Information provided in this form will inform the development of a longer-term exception process for the 30% limit on Clinic Non-panel Services. More detailed information about any changes will be shared in early 2025.

If you have questions regarding this Transition Form, please contact the FPSC Billing Support team at FP.Billing@doctorsofbc.ca.

Billing for respiratory immunizations

Family physicians play a key role in helping to protect British Columbians from respiratory viruses, especially during the winter when everyone is at greater risk.

For services provided from October 1, 2024-March 31, 2025, physicians can bill for influenza, pneumococcal, pertussis, and COVID-19 immunizations provided by allied care providers using the temporary code 98101 “LFP Respiratory Immunization Provided by an Allied Care Provider.” 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).

Detailed information is available on the BC Family Doctors website (member login required) and information is also available on the BC government website.

The Simplified LFP Guide and LFP Billing Question Library have been updated with additional information.

Reminder to submit your 2024 LFP Panel Payment claim form

The second quarter installment of the panel payment was remitted on August 31, 2024 to eligible physicians who have submitted a 2024 claim form.

If you did not submit the claim form earlier this year, you can submit it by October 18, 2024, to receive your first and/or second quarter installment with the third quarter installment on November 30, 2024.
If you have already submitted your 2024 claim form, you do not need to submit the claim form again.

Eligible physicians enrolled in the LFP Payment Model must submit an online claim form once per year to claim the panel payment for the year.

Instructions on how to claim the 2024 panel payment were emailed to individual physicians in March and June 2024. They are also being emailed in September 2024 under the title, “Action Required - Claiming your panel payment in 2024”.

Detailed Q&As on panel payments can be found in the BC Family Doctors Billing Question Library (login required). If you have any questions, please contact the FPSC Billing Support team at FP.Billing@doctorsofbc.ca.

Billing tips

Time Codes – Use ICD-9 code L23

Billing time codes with the incorrect ICD-9 code is a common billing error seen by MSP/HIBC. To avoid rejections, you must use ICD-9 code L23 when billing any time codes for clinic or facility-based care. Time codes with any other ICD-9 codes will be rejected.

These rejected claims will appear on your daily rejection report with explanatory code “BI - Fee item and diagnosis do not correspond.” You will need to resubmit these claims with the correct ICD-9 code L23 to receive payment.

Requirement to bill a Setting Registration Code (98002) for Clinic-based Services

Clinic-based care

All physicians billing clinic-based care under the LFP Payment Model must submit the LFP Clinic-based Services Registration Code (98002) in addition to their annual enrolment. Locums who provide clinic-based services are also required to do this. Submitting a clinic-based services registration code indicates that you are choosing to bill under the LFP Payment Model for clinic-based care.

Facility-based care

Physicians who wish to bill facility-based care under the LFP Payment Model must submit a Clinic-based Services Registration Code (98002) for their clinic-based care as well as a setting registration code for any facility-based areas:

Long-term care and palliative care facility services (98003),
Inpatient services (98004), and
Facility-based pregnancy & newborn services (98006)

Use the facility number associated with your longitudinal clinic when submitting your setting registration code(s). Locums should use a facility number associated with the longitudinal clinic of any of your host physicians.

To learn more about setting registration, review the billing FAQs in the BC Family Doctors Billing Question Library (login required).

Need more information?

Write us

Email: FP.Billing@doctorsofbc.ca

View our information online (member login required)

Doctors of BC: doctorsofbc.ca/new-payment-model
BC Family Doctors: bcfamilydocs.ca/lfp-payment-model
BC Government website: gov.bc.ca/MSP/LFP (login not required)