Virtual Care Professional Billing Claims - UPDATE

We've previously posted about the re-introduction of billing code 03.03AD to support physicians providing COVID-19 related advice to patients via telephone, teleconference or other virtual care support technologies. Unfortunately, physicians struggling with the need for more pandemic-appropriate remote care find the 03.03AD option a poor fit to things like remote chronic disease management and legacy telemedicine billing codes have an AHS facility requirement incompatible with social distancing.

New Virtual Care Codes
Alberta Health has released information about three new virtual care billing codes:
These codes will become available in Connect Care service code navigator within 24 hours and can be used retrospectively from March 17, 2020.

The new Virtual Care codes are intended for health services that cannot or should not be provided in-person during a pandemic. Physicians must meet all the usual standards applicable to the provision and documentation of clinical care, including:
  • Appropriate request to initiate (e.g. referral, patient request) the health service(s)
  • Appropriate clinical documentation in the legal record of care
  • Time assessments should be limited to the duration of actual patient interaction
  • Usual limits on number of assessments for the same patient (in-person or virtual) in the same day
  • Premium (time, complexity, etc.) modifiers cannot be used
  • 03.03AD should be used for virtual care services 10 minutes or less in duration
Choice of Virtual Care technology is important. The telephone can be used when this fully meets the clinical interaction need. Otherwise, AHS enterprise video conferencing (Skype for Business, AHS Zoom) has requisite privacy protections and should be used.