Fee schedule: New Mild Traumatic Brain Injury Program of Care (mTBI POC)
Effective October 5, 2020
mTBI POC block 1
New mild traumatic brain injury program of care block 1
| Services included: |
Service code |
Minimum visits |
Fees |
- Initial assessment
- Treatment: four weeks
|
MTBRTB1 |
5 |
$630 |
mTBI POC block 1 with vestibular rehabilitation
New mild traumatic brain injury program of care block 1 with vestibular rehabilitation
| Services included: |
Service code |
Minimum visits |
Fees |
- Initial assessment
- Treatment: four weeks
- Additional intervention: vestibular rehabilitation
|
MTBRTB1V |
5 |
$715 |
mTBI POC block 2
New mild traumatic brain injury program of care block 2
| Services included: |
Service code |
Minimum visits |
Fees |
|
|
MTBRTB2 |
4 |
$330 |
mTBI POC block 2 with vestibular rehabilitation
New mild traumatic brain injury program of care block 2 with vestibular rehabilitation
| Services included: |
Service code |
Minimum visits |
Fees |
- Treatment: four weeks
- Additional intervention: vestibular rehabilitation
|
MTBRTB2V |
4 |
$440 |
mTBI POC supplementary block and report
New mild traumatic brain injury program of care supplementary block and report
| Services included: |
Service code |
Minimum visits |
Fees |
- Treatment: four weeks
- Supplementary report
|
MTBRST |
3 |
$270 |
mTBI POC supplementary block with vestibular rehabilitation and form
New mild traumatic brain injury program of care supplementary block supplementary block with vestibular rehabilitation and form
| Services included: |
Service code |
Minimum visits |
Fees |
- Treatment: four weeks
- Additional intervention: vestibular rehabilitation
- Supplementary report
|
MTBRSTV |
3 |
$325 |
Reporting
New mild traumatic brain injury program of care reporting
| Services included: |
Service code |
Minimum visits |
Fees |
|
Initial assessment report
|
MTBRIAF |
NA |
$50 |
| Mid-point report |
MTBRMPR |
NA |
$30 |
| Care and outcome summary |
MTBRCOS |
NA |
$50 |
Requirements
- The health care provider must complete the initial assessment report and submit it within two business days of the assessment. If the WSIB has not received the initial assessment report within 14 days of the assessment, the report fee will not be paid.
- The health care provider must complete the mid-point report at the end of block 1 and submit it within two business days of the last treatment session in block 1. If the WSIB has not received the mid-point report within 14 days of the last block 1 treatment session, the report fee will not be paid. Payment of block 1 will be withheld until the WSIB has received the report.
- The health care provider must complete the care and outcome summary at end of block 2, or whenever discharge occurs, and submit it within two business days of the last treatment session. If the WSIB has not received the care and outcome summary within 14 days of the last treatment session, the report fee will not be paid. Payment of block 2 will be withheld until the WSIB has received the report.
- The health care provider must complete the supplementary report at the end of the supplementary block and submit it within two business days of the last treatment session. If the WSIB has not received the supplementary report, the supplementary block will not be not paid.
- The provider must deliver the minimum number of visits in each block to receive the full block fee; otherwise, the block fee will be reduced by 50 per cent.
- The provider may bill for treatment blocks that include vestibular rehabilitation when they have provided detailed reporting of objective findings to support this intervention.
Billing instructions
General
- Bill electronically for treatment through the WSIB’s payment processor, TELUS Health, at the completion of each block.
- Payment for treatment will be withheld until the WSIB has received the corresponding report.
- When billing for block 1 and block 2 of treatment, please enter the service code on one line with the number of visits (units) in the appropriate field and the corresponding fee.
- Please do not bill electronically for the supplementary treatment block; you will receive payment once the WSIB has received supplementary block report.
- If HST is applicable, record it on the same bill but on a separate line using the service code “ON-HST”.
- For further information on electronic billing, please contact the TELUS Health Support Centre at 1-866-240-7492 or visit TELUS Health.
Forms
- Submission of the initial assessment report, mid-point report, care and outcome summary will generate an automatic invoice for the report fee; electronic billing is not required for these reports.
- Submission of the supplementary report will generate an automatic invoice for the supplementary block of treatment and the report; electronic billing if not required for supplementary treatment and reporting.
- Please submit completed reports using WSIB online services.
