FAQs—FPSC funding changes: Aligning with the LFP Payment Model

Published March 5, 2024. Updated March 28, 2024

The Family Practice Services Committee (FPSC) is evolving its funding supports for inpatient and long-term care to align with the LFP Payment Model, which will include these services in June 2024. For more information, please see:

There are two sections available below:

 

 

 

 

FPSC funding changes for inpatient care

What are the important dates to know for FPSC changes for inpatient care?

This table shows important dates for current and future FPSC funding supports for inpatient care.

When can family physicians start billing LFP (Longitudinal Family Physician) Payment Model time codes and interaction codes for inpatient care services?

New LFP Payment Model (login required) time codes and interaction codes for inpatient care services will be available to eligible family physicians in June 2024. 

New FPSC On-Call/Availability Funding for Inpatient Care

What is the FPSC On-Call/Availability Funding for Inpatient Care and when will it be available?

Starting in July 2024, the new FPSC On-Call/Availability Funding for Inpatient Care will be available to support family physicians to work together to provide on-call availability to hospital inpatients. This funding will provide an amount of $182,000 (aligned with MOCAP level 2) per hospital for 24 hours/7 days per week/365 days per year. The funding will be administered by local divisions of family practices. Divisions can apply for additional funding will be available to support the administration cost of operating call groups. 

While the funding is administered by divisions, the maximum payable per participating physician is $21 per on-call hour. While a physician is on-call, all patient services they provide will be compensated by the LFP Payment Model (login required) or any other payment model (e.g. Fee-for-Service or Alternative Payments) that the physician is compensated by. 

The new FPSC On-Call/Availability Funding for Inpatient Care will be funded through a reallocation of the Assigned Inpatient Care Network Fee (14086) and the Unassigned Inpatient Care Network Funding (“GU funding”). 

More details about the funding, including division application process and additional payment parameters, will be communicated to divisions in the coming months.

Will family physicians be paid less for on-call availability with the new FPSC On-Call/Availability Funding for Inpatient Care?

Currently, payment rates for on-call availability vary significantly across the province. The new FPSC On-Call/Availability Funding for Inpatient Care is designed to provide equitable compensation for on-call availability across the province – aligned with MOCAP Level 2. Family physicians providing on-call availability will be compensated by the new FPSC On-Call/Availability Funding for Inpatient Care (up to $21 per hour) and by their applicable payment model for patient services provided while they are on-call. The LFP Payment Model (login required) for inpatient care provides significant payment premiums for direct patient care services provided after hours.

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for inpatient and long-term care at the same time?

No. If a family physician is providing on-call coverage for inpatient and long-term care at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, patient services provided in hospital or long-term care are compensated by their applicable payment models.

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for multiple communities at the same time?

No. If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, patient services provided are compensated by their applicable payment models.

Can family physicians receive on-call/availability payments from more than one division?

If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. If a family physician provides on-call coverage for one community at one time and for another community at a different time, they may receive on-call/availability payments from different divisions.

14086 – FPSC Assigned Inpatient Care Network Incentive

What will happen to 14086 (Assigned Inpatient Care Network Incentive)? Can family physicians continue to bill 14086?

14086 currently provides funding directly to individual physicians to support family physicians to work together to provide inpatient care, including on-call availability, to assigned inpatients. 

14086 is payable per calendar quarter and is billed on the first day of the first month of each calendar quarter (January 1, April 1, July 1, October 1) and is paid for the subsequent quarter. The final day for which 14086 is billable by eligible family physicians is April 1, 2024, which pays for network activities from April 1 to June 30, 2024. 

From July 2024, 14086 funding will be reallocated and replaced by the new FPSC On-Call/Availability Funding for Inpatient Care (administered by the local division of family practice) described above.

“GU” Funding – FPSC Unassigned Inpatient Care Networking Funding

What will happen to the FPSC Unassigned Inpatient Care Network Funding (“GU” funding)?

GU funding (paid by MSP Teleplan) currently provides funding to divisions or self-organizing groups to support family physicians to work together to provide inpatient care, including on-call availability, to unassigned inpatients. The GU funding will be replaced by the FPSC On-Call/Availability Funding for Inpatient Care. The final GU payment will be paid to eligible divisions and self-organizing groups in July 2024. 

From July 2024, family physicians providing on-call availability to hospital inpatients will be funded by a new FPSC On-Call/Availability Funding for Inpatient Care described above.

FPSC Bridge/Stabilization Funding for Inpatient Care

What will happen to FPSC Bridge/Stabilization Funding for Inpatient Care?

FPSC currently provides funding in the form of bridge/stabilization funding to divisions to further support inpatient care services provided by family physicians working under Fee-for-Service. FPSC has approved bridge/stabilization funding to September 30, 2024 to support communities, as needed, to transition inpatient care programs from existing funding to new payment model. FPSC Bridge/Stabilization funding installments will be released to divisions in April and June 2024. More details, including application instructions and payment parameters, will be shared with divisions in the coming weeks.

Can Divisions use FPSC Inpatient Care Bridge/Stabilization Funding to provide additional payments to family physicians providing inpatient care services under LFP Payment Model (login required) in hospital or Alternative Payments (AP) contract?

No. FPSC Inpatient Care Bridge/Stabilization Funding is not payable for inpatient care services that are compensated for by the new LFP Payment Model (login required) or AP contract. In other words, family physicians who bill under the LFP Payment Model for inpatient care (or compensated by AP contract for inpatient care) must not collect additional bridge/stabilization payments for inpatient care from the local division of family practice. 

Can divisions use FPSC Bridge Funding for Inpatient Care to provide additional payments to family physicians providing on-call coverage?

Until the FPSC On-Call/Availability Funding launches in July 2024, divisions may use the FPSC Inpatient Care Bridge Funding to provide on-call compensation to physicians within payment parameters, provided that on-call/availability is not already compensated for by AP contract or another on-call payment mechanism (e.g., MOCAP).

Once the FPSC On-Call/Availability Funding launches in July 2024, divisions may no longer use the FPSC Inpatient Care Bridge Funding to provide on-call compensation to physicians. This funding may remain unspent and returned to FPSC (per year-end unspent funding process) and/or be reallocated to another inpatient care area in the community within the payment parameters. If reallocating funding, then divisions must submit a revised bridge funding application form to fp.billing@doctorsofbc.ca for review before the funds are reallocated.

14088  - Unassigned Inpatient Care Fee

If I bill under the LFP Payment Model (login required) for inpatient care, can I still bill 14088 (Unassigned Inpatient Care Fee)?

No. The LFP Payment Model (login required) time codes and interaction codes already compensate for MRP (Most Responsible Physician) services to unassigned inpatients. Therefore, 14088 is not payable to family physicians who bill under the LFP Payment Model for inpatient care.

Will 14088 remain available for family physicians who choose to remain in Fee-for-Service for inpatient care?

Yes, 14088 will remain payable to family physicians who choose not to participate in the LFP Payment Model for inpatient care and remain in Fee-for-Service.

 

 

FPSC funding supports for Long-Term Care

What are the important dates to know for FPSC funding changes for long-term care?

The table below outlines the important dates for current and future FPSC funding supports for long-term care.

When can family physicians start billing the LFP Payment Model time codes and interaction codes for long-term care services?

New LFP Payment Model time codes and interaction codes for long-term care services will be available to eligible family physicians in June 2024. 

What will happen to the FPSC Long-term Care Initiative (LTCI)?

In July 2024, the current LTCI funding ($400 per bed) will be reallocated to fund the following :

  • FPSC On-Call/Availability Funding for LTC – administered by the divisions of family practice
  • FPSC On-Call/Availability Administration Funding for LTC – administered by the divisions of family practice
  • FPSC LTCI QI/Admin Funding for LTCI – administered by the divisions of family practice
  • FPSC LTCI Payment for FPs not eligible for LFP Payment Model – direct payments to family physicians

The final payment based on current LTCI funding formula will be released to participating divisions of family practice in June 2024.

New FPSC On-Call/Availability Funding for Long-term Care 

What is the FPSC On-Call/Availability Funding for Long-term Care and when will it be available?

In July 2024, a new FPSC On-Call/Availability Funding for Long-term Care program will be available to support family physicians to work together to provide after hours on-call availability to LTC patients. This funding program will provide an amount of $130,000 per division + $80 per LTCI bed. Divisions can apply for additional funding to support the administration cost of operating call groups.

The funding is administered by the division of family practice, and the maximum payable per participating physician is $21 per on-call hour. Additionally, while a physician is on-call, all patient services they provide will be compensated by the LFP Payment Model or any other payment model (e.g. fee-for-service or AP contract) by which the physician is compensated. 

Will family physicians be paid less for on-call availability with the new FPSC On-Call/Availability Funding for Long-term Care?

Currently, payment rates for on-call availability vary significantly across the province. The new FPSC On-Call/Availability Funding for Long-term Care is designed to provide equitable compensation for on-call availability across the province. Family physicians providing on-call availability will be compensated by the new FPSC On-Call/Availability Funding for Long-term Care program (max $21 per hour) and by their applicable payment model for patient services provided when they are on-call. 

The LFP Payment Model for Long-term Care provides significant payment premiums for direct patient care services provided after hours. 

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for inpatient and long-term care at the same time?

No. If a family physician is providing on-call coverage for inpatient and long-term care at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, the patient services they provide in hospital or long-term care are compensated by their applicable payment models.

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for multiple communities at the same time?

No. If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, the patient services they provide are compensated by their applicable payment models.

Can family physicians receive on-call/availability payments from more than one division?

If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. If a family physician provides on-call coverage for one community for one time and for another community at a different time, they may receive on-call/availability payments from different divisions.

What is the FPSC LTCI (Long-term Care Initiative) QI (Quality Improvement)/ Administration Funding? 

The FPSC LTCI QI/Administration Funding provides continued financial support to divisions to engage in local LTCI QI activities to support the iterative design and implementation of local solutions that deliver dedicated MRP (Most Responsible Physician) services for patients in long-term care facilities. Funds are based on the QI and administration budget outlined in each division's fiscal year 2023/24 MOU (memorandum of understanding). 

Funds may be used to support quality improvement and educational activities such as projects (e.g., streamlining admissions or SBAR usage), developing educational materials, mentoring, CME (continuing medical education) and LTCI Steering Committee; physician sessional time for non-clinical LTCI leadership or quality improvement activities; division administrative or LTCI project management staff support and costs supporting QI activities such as facility rental and catering costs.

More details will be communicated to divisions in the coming months.

New FPSC LTCI Payment for family physicians (under Fee-for-Service) not eligible for LFP Payment Model

What is the FPSC LTCI Payment for family physicians (under Fee-for-Service) not eligible for the LFP Payment Model (login required)?

This payment is intended to help family physicians (under Fee-for-Service), who are not eligible for the LFP Payment Model (login required), to maintain their long-term care services. Starting in July 2024, Fee-for-Service family physicians participating in the LTCI (Long-Term Care Initiative) and who are not eligible for the LFP Payment Model (login required) can claim an amount of $290 per year per long-term care bed, up to a maximum annual amount, for which they are the MRP (Most Responsible Physician). 

To be eligible for this payment, family physicians must meet all of the following requirements:

  • Be actively participating in the LTCI and providing long-term care services as of [first day of quarter] according to the following best practice expectations:
    • 24/7 availability (as a collective group) and on-site attendance when required.
    • Proactive visits to residents.
    • Meaningful medication reviews.
    • Completed documentation.
    • Attendance at case conferences.
  • Commit to maintaining long-term care services according to LTCI best practice expectations until [last day of quarter].
  • Do not meet the eligibility requirements of the LFP Payment Model. Family physicians who meet the eligibility requirements of the LFP Payment Model but choose not to participate in the LFP Payment Model are not eligible for this payment.
  • Bill under Fee-for-Service for LTC services. Family physicians who are compensated by AP contract (e.g., sessional payment or service contract) are not eligible for this payment.

More details, including how physicians can claim the payment, will be communicated in the coming months.