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Why ClinicAid?
We make your COVID billing EASY
Default Covid Recovery Patient
Billing the Covid Recovery codes is simple with ClinicAid, your account will already have a patient record set up that contains no healthcare number, version code, and no date of birth for your submissions.
Simply start typing “covid” into the patient field to auto-populate this default patient for all of the below billing codes.
K087,K088, & K089
These codes cannot be billed with a Service Location Indicator of ‘OTN’, if you attempt to save an invoice with this invalid SLI code, ClinicAid will prompt you to make a correction to avoid unnecessary rejections.
No additional premiums or payment will be allowed with these codes.
The fee billed on the claim should equal the value of the service multiplied by the number of patients serviced. For example, if K087 is claimed for 3 patients seen during the same day, the fee billed should be $71.25 (3 x $23.75).
- The claim must be submitted with the Billing Number of the physician who provided the service
- The Health Number field on the claim must be left blank
- The Version Code field on the claim must be left blank
- The Birth Date field on the claim must be left blank
- The Service Date on the claim will be the date the service was provided
H409 + H10 - COVID-19 Sessional unit per one hour period:
Billing the H409 and H410 codes is simple with ClinicAid, your account will already have a patient record set up that contains no healthcare number, version code, and no date of birth for your submissions. All COVID sessional codes will need to be submitted with the group number (M###) assigned to the hospital or PHU that coordinated the vaccine service delivery. This information should be obtained from the hospital or PHU vaccination lead for the COVID-19 Assessment Centre administrator of the coordinating entity. The group number can either be added to your provider record, or directly to the invoice for billing.
E405A: COVID Hospital Complexity Modifier:
E405A should only be billed for patients who are COVID-19 positive or who are treated as at risk of COVID-19 positive under local hospital policy. This FSC can only be billed with general anesthesia and certain procedures which are listed in Appendix A.
- E405A does not require a diagnostic code
- E405A is not payable with E400C, E401C, E409A, E410A, E412A, E413A, Q012A, Q016A, Q017A and Q018A (after-hours premiums)
- E405A is not eligible to be billed with virtual care claims
Fee codes K080A, K081A, K082A, K083A, K084A, G040A, G041A, G042A, G043A, E405A, E404A and E415A are exempt from stale date processing until June 30, 2021.
Retroactive to March 14, 2020, K-codes K080, K081, and K082 will include four point of car drug testing services, meaning that K-codes that have been submitted will count towards the minimum consult requirments for G040, G041, G042, and G043. These codes will no longer reject with error ‘AMR-Min SRV Reqmnts not met”.
- K081 – minimum of 10 minutes
- K082 – half hour or major part thereof
- The Version Code field on the claim must be left blank
- The Birth Date field on the claim must be left blank
- K083 – the total increments eligible for payment is equal to the fee listed in the Schedule of Benefits for Physicians Services for the appropriate service, rounded to the nearest $5, divided by 5
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Focused Practice Psychotherapy Premium for Virtual Care
Enable the application of the existing focused practice psychotherapy premium for eligible physicians that relates to in-person psychotherapy to psychotherapy provided by phone or video using the K082 virtual care K-code for the period of March 14, 2021 to September 30, 2021.
Virtual Care for Palliative Care
New temporary OHIP virtual care fee codes specifically for palliative care physician services by phone and video, at equivalent rates to A945 and K023, have been created for the period of March 14, 2021 to September 30, 2021.
Critical Care Premiums
Introduce a new COVID-19 temporary 30% premium (E415A) for life threatening critical care services G521, G522 and G523, in lieu of hospital hourly Protective or Pre-Emptive Code Blue Teams funding, for the period of October
1, 2020 to September 30, 2021
COVID-19; After Hours Procedure Premium; E409; E410:
E409/E410 is not payable for a procedure rendered by an Emergency Department Physician
E412/E413 is only payable for a procedure rendered by an Emergency Department Physician who at the time the service was rendered is required to submit claims using “H” prefix emergency services.
