December 20, 2023

LFP Expansion Update

Doctors of BC and BC Family Doctors continue to work with the Ministry of Health to improve, expand, and develop tools and support for the Longitudinal Family Physician (LFP) Payment Model. We continue to listen to your feedback, meeting regularly with the provincial government to address concerns. To submit questions or feedback, please email FP.Billing@doctorsofbc.ca.

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

New information on LFP Payment Model expansion.
Required annual LFP Payment Model re-enrolment starts in January.
Updated LFP Payment Schedule, effective January 1, 2024, with new locum enrolment information.
Additional time provided for panel upload and Panel Registry requirements.

Expansion of the LFP Payment Model

Today we are pleased to share an update on the LFP Payment Model expansion to facility-based care. This follows on our commitment to build a comprehensive payment model to strengthen family practice, building on the foundation of the clinic-based LFP model launched in February 2023.

Over the past several months, Doctors of BC, BC Family Doctors and the Ministry of Health have focused on the expansion into four areas of facility-based care, namely: in-patient, maternity, palliative and long-term care. We have now reached agreement on the approach, with the goal of supporting stable and sustainable service in these vital areas of facility-based care.

Overview of expanded model

This expansion builds on the principles of the LFP Payment Model, including simplicity of administration, providing equitable compensation across service areas, and maintaining professional agency and clinical judgement along with accountability to the health care system.

The expanded payment model provides payment for time and interactions, with overall daytime payment equitable to clinic based LFP compensation. There is additional compensation provided for after hours care, along with payment for availability and travel time. Rural retention premiums will continue to apply to all elements of the model.

The rates for time and interactions have been adjusted to reflect how care is delivered in facilities:

Direct patient care time ranges between $170-230/hour
Patient interactions codes are between $25-90, depending on the service being provided.

Some key features relevant to each clinical setting can be found below:

Maternity care

Facility based payments for maternity care are significantly weighted toward direct patient care time, to acknowledge the unpredictability of facility-based maternity care. There is also a surcharge on after-hours direct patient care time.

As previously announced, retroactive to December 1, 2023, physicians providing maternity care receive an availability payment (on call coverage payment) through the Medical On-Call Availability Program (MOCAP). Logistical details continue to be worked out, and we will have more information on the longer-term process in the new year.

Inpatient care

As with the other facility-based services, payments for time and interactions, while more weighted towards direct clinical time, are designed to provide equitable compensation to the LFP Payment Model clinic-based rates, with an added surcharge for after hours patient care time. Patient interaction codes have been expanded to account for unique features of care, such as consultation, consent and planning discussions, and team communication. Payment for availability recognizes the importance of being available for your own patients and also for unassigned patients.

Long-term and palliative care

Payment for service in long term and palliative care facilities is also based on time and interactions, with rates designed to be equitable to the LFP Payment Model clinic compensation. Physicians in long-term care work closely with other members of the health care team, and this is being supported with the introduction of payments for interdisciplinary care conferences and team communication, as well as consent and care planning discussions. After hours premiums will apply in both setttings, with availability payments also being applied in long-term care settings.

Next steps

In addition to working through details of implementation, discussions continue on approaches to compensation for family physicians in rural, remote, and Indigenous communities.

The LFP Payment Model has had a profound impact in helping support family physicians in providing longitudinal care, and we are excited by the opportunity to expand this model to better support the comprehensive care provided by family physicians in various facility-based care settings. We look forward to sharing more information with you, and as we did with the launch of the LFP Payment Model, we will be hosting town halls and providing more detailed information in early 2024.

LFP Physicians: Resubmit your registration code in 2024

All physicians enrolled in the LFP Payment Model must resubmit their registration code (98000) between January 1 and March 31, 2024 to continue billing under the LFP Payment Model.

If the registration code is not submitted by March 31, no subsequent payments will occur under the LFP Payment Model until it is submitted.

Please see the LFP Payment Schedule for full details on how to submit 98000.

LFP Locums: Simplified locum enrolment process

Effective January 1, 2024, there is a simplified enrolment process for LFP Locums.

All physicians providing locum services under the LFP Payment Model must do the following between January 1 and March 31, 2024 to continue billing under the LFP Payment Model:

Submit the 98005 Locum Registration Code via MSP/Teleplan.
Submit an LFP Locum registration form.

Note: Locums no longer need to submit registration code 98000 in addition to 98005. Please refer to the latest LFP Payment Schedule, effective January 1, for full details on how to submit the locum registration code as the process has changed.

New LFP Payment Schedule - dated January 1

In addition to the locum enrolment changes, a few minor changes have been made to the LFP Payment Schedule to clarify locum billing, maternity services, and ICD-9 codes.

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 to the payment schedule.

Provincial Attachment System requirements - additional time to January 31

Physicians enrolled in the LFP Payment Model, as well as longitudinal family physicians on other payment models, now have until January 31, 2024 to submit their list of patients to MSP/Teleplan and to sign into the Panel Registry. If you have not yet done this, we urge you to complete it as soon as possible. Read more in our recent news article.

A reminder that the Doctors of BC offices will be closed from December 22 until January 2, which means staff will not be available during that time to answer your questions or address concerns, but we look forward to connecting with you in the New Year!

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: https://bcfamilydocs.ca/lfp-payment-model/
BC Government website: gov.bc.ca/MSP/LFP (login not required)