To be eligible to bill MSP, a midwife should be

• licensed by the College of Midwives of British Columbia (CMBC), and
• enrolled in MSP.

Enrolled midwives are granted an MSP practitioner number (also known as MSP payment or MSP billing number) that has to be indicated in MSP claims in the field “attending midwife“.

Enrolment status and the possession of an active billing number, is contingent upon the midwife’s continued licensure by the the College of Midwives of British Columbia.

Each midwife enrolled with MSP is assigned a billing number consisting of two numbers:

• a practitioner number, which identifies the practitioner rendering the service, and
• a payment number, which identifies the person to whom payment is to be made.

MSP practitioner and payment numbers are usually the same, unless a midwife requests an additional MSP payment number.

If midwives want to make their clinic an MSP payee, the clinic can receive an MSP payment number, too.

In case of a change in address, telephone number, specialty or licence status, midwives should advise MSP. MSP requires accurate information to provide midwives with billing support and ensure their claims’ compliance.

Midwives can conveniently use Claim Manager to bill MSP.

Midwives in B.C. offer primary health care to healthy pregnant women and their newborn babies from early pregnancy, through labour and birth, and up to six weeks postpartum.

Medical Services Plan (MSP) provides the following benefits

• maternity care by a midwife;
• diagnostic services, including x-rays and laboratory services, provided at approved diagnostic facilities, when ordered by a midwife.

MSP does not provide coverage routine physical examinations performed for reasons other than medical necessity.

Midwives can use Claim Manager to

• bill MSP for the insured benefits,
• bill patients for the services not covered by MSP,
• bill patients who are not MSP beneficiaries on the day of service.

Keeping all your billing in one electronic system makes your income reporting quick and easy.

• 36010  – Total care throughout Phase 1
  • April 1, 2015 – $256.04
  • April 1, 2017 – $257.96
  • April 1, 2018 – $259.89
• 36014  – care transferred to another Midwife or physician prior to the completion of Phase 1 care.
  • April 1, 2015 – $102.41
  • April 1, 2017 – $103.18
  • April 1, 2018 – $103.95
  • Where services are terminated prior to the end of Phase 1, the Midwife may bill for 40% of the value of that Phase. Termination may be at the request of the client or due to a Transfer of Care to another Midwife or to a physician.
• 36016 – care transferred from another Midwife or a physician prior to completion of Phase 1.
  • April 1, 2015 – 153.62
  • April 1, 2017 – 154.77
  • April 1, 2018  – 155.93
  • When care is transferred to another Midwife from a Midwife or a physician prior to the completion of Phase 1, the Midwife assuming responsibility for care and completing the phase may bill for 60% of the value of the Phase.

• 36020  – Total care throughout Phase 2
  • April 1, 2015 – $256.04
  • April 1, 2017 – $257.96
  • April 1, 2018 – $259.89
• 36021 – First trimester care provided in Phase 2
  • April 1, 2015 – $256.04
  • April 1, 2017 – $257.96
  • April 1, 2018 – $259.89
  • This may be billed when an Eligible Client’s first visit occurs in 2nd trimester (phase), with no previous care by a Midwife or physician.
  • Receiving care from a physician does not include care by a physician for confirmation of the pregnancy or the one physician visit the Midwife must advise the client to have,
    as required by Midwifery Regulation.
  • The fee item may be billed in addition to 36020 at the completion of Phase 2 of care.
• 36024  – care transferred to another Midwife or physician prior to the completion of Phase 2
  • April 1, 2015 – $102.41
  • April 1, 2017 – $103.18
  • April 1, 2018 – $103.95
  • Where services are terminated prior to the end of Phase 2, the Midwife may bill for 40% of the value of that phase.
  • Termination may be at the request of the client or due to a Transfer of Care to another Midwife or to a physician.
• 36026 – care transferred from another Midwife or a physician prior to completion of Phase 2.
  • April 1, 2015 – 153.62
  • April 1, 2017 – 154.77
  • April 1, 2018  – 155.93
  • When care is transferred to another Midwife from a Midwife or a physician prior to the completion of Phase 2, the Midwife assuming responsibility for care and completing the phase may bill for 60% of the value of the Phase.

• 36030  – Total care throughout Phase 3
  • April 1, 2015 – $512.18
  • April 1, 2017 – $516.02
  • April 1, 2018 – $519.89
• 36031  – Phase 3 services for second trimester delivery
  • April 1, 2015 – $512.18
  • April 1, 2017 – $516.02
  • April 1, 2018 – $519.89
  • This fee may be billed in situations where an Eligible Client:
    • has not transferred from another Midwife; and
    • had her first antenatal visit with the Midwife during the
    first or second trimester; and
    • delivered during the second
    trimester; and
    • received care for Phases 1, 2, 4 and 5 from the Midwife
    where the postpartum care may be shared among
    Midwives.
  • This fee item may be billed at the same time as billing for Phase 4
• 36034  – care transferred to another Midwife or physician prior to the completion of Phase 3
  • April 1, 2015 – $204.87
  • April 1, 2017 – $206.41
  • April 1, 2018 – $207.96
  • Where services are terminated prior to the end of Phase 3, the Midwife may bill for 40% of the value of that phase.
  • Termination may be at the request of the client or due to a Transfer of Care to another Midwife or to a physician.
• 36036 – care transferred from another Midwife or a physician prior to completion of Phase 3.
  • April 1, 2015 – $307.30
  • April 1, 2017 – $309.60
  • April 1, 2018  – $311.92
  • When care is transferred to another Midwife from a Midwife or a physician prior to the completion of Phase 3, the Midwife assuming responsibility for care and completing the phase may bill for 60% of the value of the Phase.

• 36040  – Attendance at labour and delivery by the Midwife
  • April 1, 2015 – $1,024.18
  • April 1, 2017 – $1,031.86
  • April 1, 2018 – $1,039.60
  • Attendance at labour and delivery by the Principal Midwife. In order to bill this fee item the Midwife must attend the delivery.
• 36041  – Transferring Midwife: Attendance at labour and delivery by the Midwife – intra-partum care transferred to another Midwife or a physician.
  • April 1, 2015 – $409.68
  • April 1, 2017 – $412.75
  • April 1, 2018 – $415.85
  • This may be paid when the Eligible Client is physically transferred to another geographic location during labour.
  • The Midwife who transfers care out may bill for 40% of the value of Phase 36040.
  • This fee item may not be paid along with 36040 or 36042.
• 36042  –Receiving Midwife: Attendance at labour and delivery by
  the Midwife – intra-partum care transferred from another Midwife or a physician.

• April 1, 2015 – $614.50
• April 1, 2017 – $619.11
• April 1, 2018 – $623.75
• This may be paid when the Eligible Client is physically transferred to another geographic location during labour. The Midwife who receives the transferred client may bill for 60% of
  the value of Phase 36040.
• This fee item may not be paid along with 36040 or 36041.or 36045.
• 36045 – Home Birth Second Attendant fees
  • April 1, 2015 – $353.50
  • April 1, 2017 – $356.15
  • April 1, 2018  – $358.82
  • Second attendant services rendered by a Midwife must be claimed by the Midwife who performs the service.
  • Services rendered by a second attendant who is recognized by the CMBC but is not a Midwife will be claimed by the Principal Midwife.
  • The name of the second attendant must be included in the note
    record of the claim.
  • This fee item must be claimed with location code “R”.
• 36046 –Home Birth medications
  • April 1, 2015 – $50.00
  • April 1, 2017 – $50.88
  • April 1, 2018  – $51.26
  • Reimbursement to the Principal Midwife for all pharmaceutical supplies required by the CMBC for Home Birth.
  • This fee item can only be paid when claimed with location code “R” and must be claimed by the Principal Midwife.
  • The fee will only be paid when a corresponding claim is paid for fee item 36047.
• 36047 – Home Birth supplies
  • April 1, 2015 – $101.00
  • April 1, 2017 – $101.76
  • April 1, 2018  – $102.52
  • Reimbursement to the Principal Midwife for all disposable supplies required by the CMBC for Home Birth.
  • This fee item can only be paid when claimed with location code “R” and must be claimed by the Principal Midwife.
  • The fee will only be paid when a corresponding claim is paid for fee item 36046.
• 36048 – Supportive Care for Scheduled Caesarean Section in the operating room
  • April 1, 2015 – $101.00
  • April 1, 2017 – $101.76
  • April 1, 2018 – $102.52
  • A Principal Midwife or an appointed Midwife may bill this fee item while attending a Scheduled Caesarean Section.
  • This fee will only be paid if a corresponding claim from the same Midwife is paid for fee item 36049.
  • May not be paid with fee item 36040.
• 36049 – Supportive Care for Scheduled Caesarean Section Recovery
  • April 1, 2015 – $101.00
  • April 1, 2017 – $101.76
  • April 1, 2018 – $102.52
  • A Principal Midwife or an appointed Midwife may bill this fee item when providing supportive care within the first three hours following a Scheduled Caesarean Section.
  • This fee will only be paid if a corresponding claim from the same Midwife is paid for fee item 36048.
  • May not be paid with fee item 36040.

• 36050  – Total care throughout Phase 5
  • April 1, 2015 – $1,024.18
  • April 1, 2017 – $1,031.86
  • April 1, 2018 – $1,039.60
  • Attendance at labour and delivery by the Principal Midwife. In order to bill this fee item the Midwife must attend the delivery.
• 36056  – Care transferred to another Midwife or physician during first 2 weeks of postpartum care or termination of service by the Eligible Client
  • April 1, 2015 – $614.51
  • April 1, 2017 – $619.12
  • April 1, 2018 – $623.76
  • Where care is transferred from a Midwife to another Midwife or physician at any time during the first 2 weeks of postpartum care, the Midwife who transfers the care will receive 60% of the value of the phase.
  • Where care with the Midwife is terminated, such termination may be at the request of the Eligible Client or due to a Transfer of Care to another Midwife or to a physician.
• 36054  – Care transferred from another Midwife or physician during the first 2 weeks of postpartum care
  • April 1, 2015 – $409.68
  • April 1, 2017 – $412.75
  • April 1, 2018 – $415.85
  • Where care is transferred from another Midwife during first 2 weeks of postpartum care, the Midwife who assumes the care and completes the Phase may bill for 40% of the value
    of the Phase.

Midwives cannot opt out of MSP Fee Schedule and charge MSP beneficiaries more. Billing MSP for services that are not on the MSP Fee Schedule or billing MSP for higher amounts is not permitted.

Claim Manager offers built-in, searchable, automatically updated catalogues of MSP Fee Schedules for midwives. Midwives can create their own custom fee schedule to bill patients who are not MSP beneficiaries.

MSP Enrollment for the Patients

Under the Medical Protection Act, eligible residents of B.C. must enrol themselves and their dependents with Medical Services Plan (MSP). If your patients have questions about MSP enrollment eligibility, please refer them to the MSP eligibility and enrollment web page.

BC Services Card

MSP enrollment is confirmed by issuing an applicant the BC Services Card (former BC CareCard). Being presented with the healthcare card is not enough to verify patient’s MSP enrollment or MSP Premium Assistance status because the patient may carry a prematurely expired MSP card and because MSP Premium Assistance status is not indicated on the card. To verify the patient’s MSP eligibility on the date of service, practitioners need to make an eligibility inquiry to MSP.

Midwives can check their patients eligibility for MSP benefits by using MSP Eligibility request. A patient is eligible if the MSP Eligibility report reads that the patient

• “Is Eligible for Medical Coverage Under MSP” on the date of service.

The four ways to check MSP status of the patients.

1. Request an instant MSP eligibility report in Claim Manager.
2. Call the automated Practitioner Information Line:
   • Victoria: (250) 952-3102 or (250) 383-1226
   • Vancouver: (604) 669-6667
   • Toll-free: 1 800 742-6165
3. Use MSP Web Access.
4. Fax a request on a coverage research form if the PHN is unknown:
   • fax: (250) 952-3101.

Notes:

1. The services are listed in an order of convenience.
2. The patient’s personal health number (PHN) must be provided for steps 1, 2 and 3.
3. MSP Teleplan registration is required for steps 1 and 3.
4. Practitioner Information Line is an automated service that handles coverage inquiries using an interactive voice response (IVR) system.

Claim Manager conducts a real time MSP eligibility check on date of service within last six months.

To obtain an Opted In MSP practitioner number:

1. Complete Application for MSP Billing number for midwives form (HLTH 2848)
2. Fax this form to the number indicated on its bottom
3. Call Teleplan support in three business days to follow up.

To obtain your MSP Teleplan Data Centre

1. Complete Application for Teleplan Service (HLTH 2820)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

To request direct bank payment from MSP (optional)

1. Complete  Application for direct bank payment from MSP (HLTH 2832)
2. Fax it along with a copy of your void check to the number on its bottom.

To make an Assignment of Payments

1. Complete Assignment of Payment Due to Practitioner under the Medical Service Plan (HLTH 2870)
2. Fax it to the number on its bottom
3. Follow up in three business days

• Midwifery Master Agreement (PDF, 588KB) – signed February 13, 2015
• Midwifery Rural Services Subsidiary Agreement (PDF, 85KB) – signed February 13, 2015
• Midwifery Preamble and Payment Schedule (PDF, 103KB)

MIDWIVES LABORATORY SERVICES REFERRAL SCHEDULE

Effective October 1, 2015

Midwives may refer beneficiaries for the following prescribed fee-for-service outpatient laboratory medicine services (benefits), provided the service falls within the midwives’ scope of practice. Midwives may also refer for medically required non fee-for-service insured laboratory medicine tests approved within the midwives’ scope of practice.

• FEE ITEM DESCRIPTION – FEE CODE
• ALANINE AMINOTRANSFERASE – 91065
• ALBUMIN CREATININE RATIO (ACR) – 91985
• ALBUMIN, SERUM/PLASMA – 91040
• ALKALINE PHOSPHATASE – 91070
• ALPHA FETOPROTEIN – 91095
• ALPHA-THALASSEMIA,MOLECULAR TESTING FOR COM DEFECT – 90029
• ANAEROBIC CULTURE INVESTIGATION – 90605
• ANTIBIOTIC SUSCEPTIBILITY TEST – SEMI-QUANTITATIVE –  90615
• ANTIGLOBULIN COOMBS TEST – DIRECT – 90080
• ASPARTATE AMINOTRANSFERASE – 91210
• BILIRUBIN TOTAL, SERUM/PLASMA – 91245
• BILIRUBIN, DIRECT – 91250
• BIOCHEMICAL IDENTIFICATION – MICRO-ORGANISM – 90620
• BLOOD FILM REVIEW – 90465
• C – REACTIVE PROTEIN – 91300
• CALCIUM TOTAL, SERUM/PLASMA – 91326
• CANDIDA CULTURE – 90640
• CERVICAL CULTURE – 90736
• CHLAMYDIA TRACHOMATIS USING NAAT – URINE – 90651
• CHLAMYDIA TRACHOMATIS USING NAAT -UROGENITAL SWAB – 90652
• CHLORIDE, SERUM/PLASMA – 91366
• COMBINED VAGINO-ANORECTAL OR VAGINAL CULTURE – 90739
• COOMBS – INDIRECT – 90300
• CREATININE, RANDOM URINE – 91420
• CREATININE, SERUM/PLASMA – 91421
• CREATININE, TIMED URINE COLLECTION – 91422
• CYTOGENETIC ANALYSIS – CHORIONIC VILLUS – 93025
• CYTOGENETIC ANALYSIS – CULTURED AMNIOTIC FLUID – 93030
• CYTOGENETIC ANALYSIS – CULTURED TISSUE – 93035
• CYTOGENETIC ANALYSIS/FLUORESCENCE IN SITU, SINGLE – 93051
• FEE ITEM DESCRIPTION FEE CODE FERRITIN, SERUM – 91645
• FIBRINOGEN, QUANTITATIVE, CHEMICAL – 91650
• FOETAL CELL STAIN – 90180
• FREE T4 – 92330
• GENITAL CULTURE – OTHER SITE – 90741
• GLUCOSE – 2 HR, POST-75G – 91719
• GLUCOSE TOLERANCE TEST, 2 – 5 HOURS – 91715
• GLUCOSE TOLERANCE TEST-GESTATIONAL PROTOCOL – 91695
• GLUCOSE, GESTATIONAL ASSESSMENT – 91690
• GLUCOSE, QUANTITATIVE SERUM/PLASMA – 91707
• GLUTAMYL TRANSPEPTIDASE (GTP) – 91725
• GONORRHEA BY NAAT-URINE – 90653
• GONORRHEA BY NAAT-UROGENITAL SWAB – 90654
• HAEMATOLOGY PROFILE – 90205
• HAEMOGLOBIN ONLY – 90230
• HAEMOGLOBIN, A1C – 91745
• HAEMOGLOBIN-CYANMETHAEMOGLOBIN – 90225
• HEMOGLOBIN ELECTROPHORESIS – 90240
• HEPATITIS B CORE ANTIBODY (ANTI-HBC) – 90690
• HEPATITIS B SURFACE ANTIBODY (ANTI-HBS) 90700
• HEPATITIS B SURFACE ANTIGEN – 91765
• LACTATE DEHYDROGENASE, SERUM/PLASMA – 91901
• MAGNESIUM, SERUM/PLASMA – 91957
• PHOSPHATES, SERUM/PLASMA – 92071
• PLATELET COUNT ONLY – 90395
• POTASSIUM, SERUM/PLASMA – 92100
• PREGNANCY TEST – SERUM – 92110
• PREGNANCY TEST, IMMUNOLOGIC – URINE – 92108
• PRIMARY BASE FEE – CHEMISTRY – 91000
• PRIMARY BASE FEE (COLLECTING) – CHEMISTRY – 91005
• PROTEIN TOTAL, SERUM OR PLASMA – 92148
• PROTEIN, TIMED URINE COLLECTION – 92146
• PROTHROMBIN TIME/INR – 90440
• QUANTITATIVE BETA HCG – 92160
• ROUTINE CULTURE – 90720
• SEROLOGICAL IDENTIFICATION -MICRO-ORGANISM – 90725
• SICKLE CELL IDENTIFICATION – 90525
• SODIUM, SERUM/PLASMA – 92231
• SPLIT BASE FEE (REFERRAL FACILITY) – 91010
• STAINED SMEAR – 90740
• THALASSEMIA/HEMOGLOBINOPATHY INVESTIGATION – 90540
• THROAT OR NOSE CULTURE – 90775
• THROMBOPLASTIN TEST, PARTIAL – 90370
• THYROID STIMULATING HORMONE, TSH – 92325
• THYROPEROXIDASE ANTIBODIES – 92332
• TRICHOMONAS AND/OR CANDIDA, DIRECT EXAMINATION – 90785
• TRICHOMONAS ANTIGEN TEST – 90784
• UREA, SERUM/PLASMA – 92368
• URETHERAL CULTURE – 90738
• URIC ACID, SERUM/PLASMA – 92376
• URINALYSIS – OR ANY PART OF (SCREENING) – 92385
• URINALYSIS, MACROSCOPIC – 92390
• URINALYSIS, MICROSCOPIC – 92395
• URINALYSIS-MICROSCOPIC EXAM OF CENTRIFUGED DEPOSIT – 92391
• URINE COLONY COUNT CULTURE – 90790
• VAGINAL CULTURE – 90737
• VENEPUNCTURE – 90000
• VITAMIN B12 – 92450

All medical services provided by these specialists, resulting from a referral by a midwife, will be processed as per MSP policy.

• Specialty – Specialty Code
• Anaesthesia – 18
• Cardiology – 26
• Dermatology – 01
• Endocrinology – 51
• Gastroenterology – 56
• General Surgery – 08
• Hematology Oncology – 74
• Infectious Diseases – 67
• Internal Medicine – 15
• Nephrology – 59
• Obstetrics & Gynaecology – 05
• Orthopedic Surgery – 10
• Paediatrics – 14
• Psychiatry – 03

All procedures, resulting from a referral by a midwife, will be processed as per MSP policy.

• Fee Item Name – Fee Code
• Amniocentesis, Transabdominal – 00787
• Doppler Echocardiography – 08679
• Foetal Heart Monitoring – Interpretation Only – 0079
• Guided Amniocentesis – 04680
• Injection, Venepuncture – 00012
• Obs B Scan (14 weeks gestation or over) – add fetuses – 86051
• Obs B Scan (<14 weeks/nuchal translucency) – add fetus – 86056
• Obs B Scan (<14 weeks/nuchal translucency) – singles – 86055
• Pelvic B Scan – Non-Obstetrical – 08653