Memo Note Department of Health / Ministère de la Santé Medicare and Physician Services Assurance-maladie et Services aux médecins P.O. Box/C.P. 5100 Fredericton, NB E3B 5G8 Tel/Tél. (506) 444-3633 Date : July 2018 Ref./Réf. : To/Dest. : All Physicians; VP Medical; VP Finance – Regional Health Authorities (RHA); Recipient of NB Physicians’ Manual Subject/objet : 2016-2018 FFS Distribution/Joint Oversight Changes The enclosed documents (Attachments A & B) provide information on agreed upon changes to the New Brunswick Physicians’ Manual related to the 2016-2018 FFS Fee Distribution (Attachment A) and changes resulting from the work of the New Brunswick Medical Society (NBMS) and Department of Health (DH) Joint Oversight Committee (Attachment B). Attachment A (2016-2018 FFS Fee Distribution): This document includes all changes related to the allocation of the 1% negotiated increase for each of the first two years (2016/2017) and (2017/2018) of the Physician Services Master Agreement between the Province of New Brunswick and the NBMS. The new rates resulting from the 2016-2018 Fee Distribution will be retroactive to April 1, 2017 or on a go-forward basis depending on the individual item as indicated in Attachment A. Your billing software should be updated by 8:30 am August 16, 2018, the effective date. MCE web services will be taken offline at 8:00 am August 16, 2018 in order to implement required updates to the system. Once changes are completed the services will be back online. You will not be able to bill the new service codes or amounts before this date. After this date, you are responsible for billing the new rates. No other retroactive payments/adjustments will be made for services after this date. Should your billing software not be updated by August 16, 2018, please contact MCE User Support at (506) 453-8274 or your third party billing software vendor. Unless otherwise stipulated in Attachment A, retroactive payments for Fee-For-Service increases will be completed by the end of October 2018 for services paid for the period of April 1, 2017 to August 16, 2018. A memo on retroactive payments for sessional hourly and manual rate increases for services rendered for the period April 1, 2017 to August 16, 2018 will be sent out separately. Attachment B (NBMS/DH Joint Oversight Committee): 1 The Joint Oversight Committee was created as part of the current Physician Services Master Agreement to deal with ongoing contract management issues over the term of the Master Agreement. These issues include Fee Schedule changes, review of billing and assessment rules and any other ongoing administrative and/or financial/economic matters related to the contractual relationship between the parties for FFS, Salaried and AFP/APP physicians. Attachment B contains these agreed upon changes. Retain this letter and the attachments until such time as the updates are implemented in the Physicians’ Manual and posted on-line. PLEASE PROVIDE YOUR BILLING STAFF WITH A COPY OF THE DOCUMENT CONTAINING THESE CHANGES. If you have any questions about these changes, please do not hesitate to contact the NBMS at (506) 458-8860, Practitioner Enquiries at (506) 444-5860 (English) or (506) 444-5876 (Bilingual). Michel Léger Director, Medicare and Physician Services cc: New Brunswick Medical Society Medicare Claims Inter-Team Medicare-Eligibility & Claims 2 ATTACHMENT A 2016/2018 ALLOCATION DOCUMENT PLEASE PROVIDE YOUR BILLING STAFF WITH A COPY OF THE DOCUMENT CONTAINING THESE CHANGES. 1) UNIT VALUE INCREASES Unit value increases effective April 1, 2017 Certified / Uncertified Specialties Old Unit New Unit Specialty Value Value General Practice – $1.52 $1.52 GP Anaesthesia $18.04 $18.06 Anaesthesia – General $1.51 $1.52 Anaesthesia $18.04 $18.06 Cardiac Surgery $1.14 $1.14 Dermatology $1.49 $1.49 Diagnostic Radiology $1.34 $1.34 - Uncertified $1.01 $1.01 Emergency Medicine $1.52 $1.52 General Internal Medicine $1.14 $1.16 Laboratory Medicine (includes Medical $1.13 $1.14 Microbiology, General Pathology, Anatomical Pathology) General Surgery (includes Thoracic and $1.30 $1.31 Vascular) Generic $1.01 $1.01 Internal Medicine (includes Medical Oncology, $1.13 $1.14 Radiation Oncology, Geriatric Medicine) Neurology $1.46 $1.48 Nuclear Medicine $1.39 $1.39 - Uncertified $1.04 $1.04 Neurosurgery $2.28 $2.28 Obstetrics & Gynaecology $1.36 $1.38 Ophthalmology $1.18 $1.19 Orthopaedic Surgery $1.29 $1.29 Otolaryngology – Head and Neck Cancer $1.06 $1.07 Paediatrics $1.44 $1.45 Physical Medicine and Rehabilitation $1.83 $1.84 Plastic Surgery $1.53 $1.54 Psychiatry $1.32 $1.34 1 Old Unit New Unit Specialty Value Value Respirology $1.59 $1.59 Rheumatology $1.31 $1.31 Standard Surgical Assist $1.53 $1.54 Urology $1.26 $1.27 Walk-in Clinic $1.05 $1.05 PLEASE PROVIDE YOUR BILLING STAFF WITH A COPY OF THE DOCUMENTS CONTAINING THESE CHANGES. 2) UNIT INCREASES Effective April 1, 2017 Service Old New Code Description Units Units 1 Office Visit 30 31 7 Complete physical exam 36 38 10 Consultation 50 53 12 Repeat Consultation, within 30 days 31 38 14 Obstetrical Delivery 395 410 16 Pre or Post Natal Visit 30 31 19 Well Baby Care Visit 30 31 26 New condition seen for the first time to include complete history and physical examination 48 53 27 First visit with regional examination 33 36 28 Subsequent visit with complete examination 48 52 29 Other office visit 41 44 31 Consultation 85 87 33 Repeat consult 66 68 35 First visit with complete examination and diagnostic survey not attended during the previous 90 days 71 75 36 First visit with regional examination 47 52 38 Other office visits 46 47 41 Consultation 129 131 42 Repeat consultation – within 30 days for same illness or complication thereof 98 101 58 Obstetrical Delivery 480 495 64 First visit with complete ophthalmological examination 45 46 65 First visit not requiring a complete exam 28 29 66 Other office visits, not including special tests or procedures 29 30 69 Major Consultation 81 82 71 Repeat consult 51 52 77 Office visit – regional exam 42 45 78 Other Office visit 41 44 2 Service Old New Code Description Units Units 81 Major or Regional Consultation 80 83 83 Repeat consultation - within 30 days for same illness or complication thereof 50 53 85 Office visit with complete exam 68 71 86 Office visit with regional exam 52 54 87 Other Office visit 46 48 90 Subsequent visit with complete re-examination 96 102 91 Neurodevelopmental examination for learning 225 228 disabilities 93 Consultation 157 161 94 Repeat consultation – within 30 days for same illness or complication thereof 97 101 102 First visit, transferred or not transferred, requiring complete history and detailed examination 46 47 103 First visit not requiring complete examination 34 37 104 Office visit - other 34 35 107 Major or Regional Consultation 83 85 109 Repeat consultation - within 30 days for same illness or complication thereof 52 54 157 Office visit with regional exam 42 50 159 Other Office visit 40 47 160 Subsequent visit for complete reassessment of a previously referred patient; allowed once in any 30 day period 64 65 161 Major or Regional Consultation 99 100 162 Repeat consultation – within 30 days for same illness or complication thereof 66 68 203 Office visit – first visit with regional exam 33 35 282 Other Referral – Complete Ophthalmological Exam 81 82 288 First visit with complete examination not attended during the previous 90 days 45 55 290 Other office visits 42 51 305 Consultation 67 68 306 Repeat Consultation 37 38 307 Office visit – first visit – complete history and physical exam 46 48 308 Other office visit 39 44 321 Consultation 212 214 322 Repeat consultation – within 30 days for same illness or complication thereof 86 88 333 Electroconvulsive Therapy 42 70 340 Diagnostic and/or Therapeutic interview, per ¼ hr 45 53 345 Repeat consultation – within 30 days for same illness or complication thereof 47 48 346 Office visit - New condition seen for the first time, to include complete history and physical examination 43 44 3 Service Old New Code Description Units Units 347 Office visit – first visit with regional examination only 37 38 835 Hysterectomy - Laparoscopic assisted Vaginal Hysterectomy 485 500 1084 Repeat consultation – within 30 days for same illness or complication thereof 45 48 1404 Caesarean section 425 471 1406 Operative delivery, other than by caesarean section 370 561 1413 Multiple births, either vaginal or caesarean section deliveries – per additional birth, add 205 226 1436 Colpocleisis (LeFort) 277 304 1454 Excision- Myomectomy 277 339 1458 Hysterectomy (Partial or subtotal) 239 304 1463 Amputation of cervix 139 200 1505 Major or regional consultation 75 78 1999 Tray fee for pap test 9 11 2954 Post-cancer treatment laparotomy, or staging laparotomy, for ovarian carcinoma 350 400 8106 Review for Referral 30 31 8116 Methadone Visit 30 31 8177 McCall Suture or McCall culdoplasty, add 50 60 8242 First office visit with complete exam and diagnostic survey of a new patient not attended during the previous 90 days 64 69 8243 First office visit with regional exam 43 48 8244 Subsequent visit with complete re-examination 43 48 8245 Other Office visit 39 43 8310 Major or Regional Consultation 132 135 8311 Repeat consultation – within 30 days for same illness or 72 75 complication thereof 8344 First Visit with complete exam 79 83 8345 First visit with regional exam 53 71 8346 Subsequent visit with complete re-examination 54 70 8347 Other office visits 52 67 8701 Caesarian Section (restricted to Spec. Obs/Gyn) 530 568 8702 Caesarean hysterectomy, subtotal or total (restricted to 600 660 Spec.