January 27, 2023

Update on the launch of the Longitudinal Family Physician Payment Model – webinar recording now available

The purpose of this newsletter is to provide the latest updates on the implementation of the Longitudinal Family Physician (LFP) Payment Model, as we move toward the launch date of February 1.

Last week, we shared the new LFP Payment Schedule with you. It provides detailed information about the payment model, including eligibility, enrollment, and billing codes. Today, we are providing the following updates:

Information webinars

Two information webinars took place this week. Thank you to those who participated and apologies to those who were unable to join the Tuesday session due to capacity issues. We expanded our audience capacity so that everyone who registered for the Thursday session was able to join.

The recorded webinar is now available for viewing. Please note that the information in this webinar is continuing to evolve. Billing questions submitted through the webinar will be incorporated into the BC Family Doctors’ Billing Question Library (see more information below).

New resources from BC Family Doctors

BC Family Doctors has new LFP Payment Model tools available on their website, written by physicians for physicians. The Simplified LFP Guide provides a plain language guide to the new payment schedule. The Billing Question Library has detailed information on all areas of billing under the payment model. These resources are available on the members-only section of the BC Family Doctors website. If you are not yet a member, you can join BC Family Doctors.

Guidance about expense and overhead sharing

Many doctors have been asking for more information about how to navigate expense sharing if they move to the LFP Payment Model. The Doctors of BC Business Pathways program is developing comprehensive resources to help physicians integrate expense sharing into practice agreements. While the full resources will be available in early February, Business Pathways is sharing information on how physicians can start to prepare.

How to enroll in the LFP Payment Model

Physicians will be able to start billing under the new model on February 1. Information and answers to your questions on how to enroll can be found on the Doctors of BC and BC Family Doctors websites (member login required).

You must bill the Registration Code at least one business day prior to billing under the LFP Payment Model.

As the work to get the LFP Payment Model launched is happening rapidly, some EMRs are still updating their systems. You may need to use an alternative enrollment mechanism if enrolling in the next few days:

If your EMR does not recognize the ICD-9 code L23, you can use ICD-9 code 780.
If the registration code still doesn’t work, contact your EMR vendor.
If your EMR vendor cannot resolve the issue, please contact Health Insurance BC (HIBC) who can assist with an online enrollment option.

If ICD-9 L23 is still not working in your EMR by February 1, you may need to use ICD-9 code 780 for billing time codes. (These codes also require ICD-9 code L23.)

Answers to your questions

Here are the Doctors of BC and BC Family Doctors websites where you can find answers to your questions. These are updated regularly.

When will locums be able to enroll?

We are working with government to put this in place as quickly as possible. We are hopeful that this will be available by the end of March. Watch for updated information to confirm specific timelines.

We have confirmed how locums will bill under the new payment model. When providing locum coverage for a FP who is being paid under the LFP Payment Model, locums will bill for time spent providing patient care (time codes) and patient interactions (patient interaction codes). They will not receive a panel payment.

If locum physicians are covering for a longer period of time, such as parental leave, we recommend that locum and host physicians discuss adjusting compensation to recognize the longer-term commitment to the patient panel.

Why are services provided by family physicians in facilities (inpatient/maternity/emergency care and long-term care) not included in the LFP Payment Model?

We recognize this is an area of concern and understand the importance of this for many physicians.

The new payment model was developed in response to an urgent need to retain and attract family physicians in community longitudinal practice. It is just the start of our work. In the coming months, we will be focusing on expanding the payment model to include services provided by community longitudinal family physicians in facilities, including inpatient, maternity, emergency, and long-term care. You can continue to bill fee-for-service for these services, even when joining the new payment model.

It is also a priority to adapt the LFP Payment Model to better reflect the realities of rural medicine. We encourage physicians providing services in rural communities to continue to provide facility-based care for your patients as we work to develop a more comprehensive approach to rural family medicine. We are working to provide more information on rural family medicine and the LFP Payment Model as soon as possible.

We will continue to update you on specific timelines and are hoping to have more information to share with you soon.

How is the feedback from physicians being incorporated into the LFP Payment Model?

Doctors of BC and BC Family Doctors continue to meet regularly with the Ministry of Health to further develop the LFP Payment Model, address issues of concern, and expand the model to additional settings.

Over the last week, we have heard concerns from new-to-practice and other physicians about not being able to enroll without an established panel of 250 patients. Already, we have met with government to discuss the possibility of changing this requirement such that physicians would have a period of a few months after enrollment to acquire the necessary 250 minimum panel.

Similarly, we have heard that physicians who provide a combination of longitudinal care and episodic care/focused practice find the 30% maximum of non-panel services to be challenging. This is another topic that we are actively discussing with government to see how we can allow for support and transition of episodic or focused practices that may want to adopt this model.

We hope to have more definitive information on both these topics to share with you in the coming days.

Need more information?

Write us

Email: LFP.Billing@doctorsofbc.ca

View our information online (member login required)

Doctors of BC: doctorsofbc.ca/new-payment-model
BC Family Doctors: bcfamilydocs.ca/a-new-choice-for-compensation
BC Government website: gov.bc.ca/MSP/LFP