Mainpro+ Credits and Billing Codes
Mainpro+ credits
Improving case finding for bipolar disorder can count towards your professional development. Implementing the RMS qualifies as a Quality Improvement (QI) project, meaning it is eligible for Mainpro+ credits through the College of Family Physicians of Canada (CFPC).
To claim your 5 Mainpro+ credits, you are required to:
Implement the RMS in your clinical workflow to identify patients who may have bipolar I disorder among those who score for mild to severe depression on the
PHQ-9.Six to twelve weeks after implementing the RMS into your clinical workflow, complete a Linking Learning to Practice reflection exercise.
Submit your reflection through your Mainpro+ account to claim your credits.
You can complete multiple Linking Learning to Practice exercises per Mainpro+ cycle, as long as each exercise represents a distinct learning opportunity.
Billing codes by province
When your patients are correctly diagnosed, everyone benefits. Different provinces have programs and billing codes that recognize primary care physicians who go the extra mile for patients with complex mental health needs. Please select the province you work in to find out more information.
*Billing code information for other provinces may be available soon.
Alberta
Complexity-Adjusted Panel Payments
Alberta provides complexity-adjusted panel payments for patients based on their complexity category. Bipolar disorder is explicitly classified as a “Major Mental Health” condition under CIHI's Population Grouping Methodology (HPG Q010 without significant comorbidities; Q011 with significant comorbidities), which Alberta uses to determine complexity-adjusted panel payments.
Depending on the age and sex of the patient, payment can range from $52.88 to $136.73 per patient per year.
British Columbia
PG14043 (FP Mental Health Planning Fee)
PG14044–14048 (Mental Health Management Fees)
Payment is tied to completion and documentation of a care plan for patients with a mental health diagnosis, including bipolar disorder. This code is not meant to be a routine annual planning visit, but only for patients whose mental illness is significant enough to warrant a review of their management plan annually.
$100.62 per patient per year.
$56.76–$85.12 per additional ≥20-minute counselling visit, depending on age
(maximum of four in a calendar year).
Manitoba
Family Medicine Plus (FM+) Mental Health Cluster (Tariff 8190)
Doctors who provide care for patients with bipolar disorder, schizophrenia, depression, anxiety, ADHD/ADD and borderline personality disorder within the last 24 months qualify. If the patient already has another mental health diagnosis, the amount does not increase (i.e., stays at $31.20). In addition, the physician must be providing ongoing qualifying care.
$31.20 per patient per quarter.
Newfoundland & Labrador
MCP Fee Code 127 — Chronic Disease Management
The physician must have a patient diagnosed with any ICD-9 code between 290–319 (bipolar is 296), spend at least 15 minutes with the patient, and ensure that the condition is the principal reason for the visit. If this fee is claimed, no other fee can be claimed by the physician.
$49.48 per patient per visit.
Ontario
Primary Care Serious Mental Illness (PC-SMI) Special Premium
Physicians in eligible primary care models (e.g., FHO, FHN, FHG) can receive the PC-SMI Special Premium by adding tracking codes Q020A for bipolar disorder and/or Q021A for schizophrenia to visits with rostered patients who have these diagnoses.
Caring for 5 eligible rostered patients per year qualifies you for a Level 1 annual bonus of $1,200, while caring for 10 or more patients unlocks Level 2 for a total bonus of $2,400 per year.
Quebec
Forfait annuel de prise en charge de la clientèle vulnérable
Patients with bipolar disorder are considered “vulnerable patients” and therefore, physicians are eligible to bill for an annual vulnerable patient care management fee.
$59.80 per patient per year in a physician’s office.
$44.95 per patient per year in a CLSC.