SSC Fee Codes – fixed budgets and constructive fee codes

The Specialist Services Committee (SSC) is allocated a fixed budget, some of which was used to create telephone fees for specialists (10001, 10002, 10003, 10004). The intent was to compensate specialists for giving telephone advice to a GP or other health professional, which could prevent a patient needing to be seen in person. These codes have been so successful that their use has exceeded the total budget available. A number of meetings between specialists and the SSC have been held, leading to the SSC tightening up the allowed use of these codes. For example, the 10001 will not be billable if the patient has been seen within 180 days, the 10002 not billable if patient seen within 30 days, and so on. A possible resulting paradox could be that, rather than billing $60 for successfully advising a GP on managing a patient, the specialist may end up consulting in person on a patient for a much higher cost. Alternatively,  specialists may be expected to provide some services for free. The original idea of compensating specialists for work they do may be less helpful than we would have hoped.

SSC telephone advice codes

Restrictions on billing telephone advice codes include limiting fee codes if patients have been seen within 180 days (10001) or 30 days (10002), but only for the same condition, that is, the same ICD code. For example, a patient first seen with abdominal pain (ICD code 7890) may then be seen within the restricted time period (180 days – 10001/30 days – 10002),  and telephone advice may again sought by a GP. Perhaps now, however, the diagnosis of Cholelithiasis is able to be made (ICD Code 5740). Because it is a different ICD code, the 10001 or 10002 may still be billed. So be careful, and accurate. The first visit’s more general diagnosis may legitimately be fine-tuned, leading to removing a possible restriction on giving telephone advice, and allowing appropriate specialist compensation after all.

Be a representative

The new governance structure at the Doctors of BC commences September 2017 – this fall! The Specialists of BC has worked very hard to ensure there would be 50% specialist representation on the new nine-member Board, and also on the approximately 100-member Representative Assembly (RA). The RA will meet just three times per year, and we really want our hard-won 50% representative seats for specialists to be filled. Specialist to specialist, I ask you to consider running for a district or rural seat as appropriate for where you live and practice. Your travel expenses and a sessional stipend would be paid. Please put your name forward and participate in the future direction of all doctors in BC.

Did you know?

The Specialists of BC is separate from the Specialist Services Committee and the Doctors of BC, though we work closely with both.  We’re a registered non-profit society working for the specialist doctors of the province since 1990, and we rely on your dues to do this work. If you want to support specialists, please considering joining the Specialists of BC now . We are currently offering 50% off membership, and you can join for $225 at https://www.doctorsofbc.ca/account/dues (the reduction will be applied automatically).