Use your CME dollars! Deadline to use is March 31. Read more.

PCPCM In-Basket Fee Codes

Review in-basket Health Service Codes and descriptions for the Primary Care Physician Compensation Model (PCPCM).

The PCPCM uses existing fee-for-service (FFS) Health Service Codes (HSC). Approximately 94% of HSCs used by community Family Medicine are included under the PCPCM and are referred to as “in-basket.” 

In-basket HSCs are paid at 68.5% of the FFS value. Complexity modifiers CMGP and CMXC30 are not paid under the PCPCM. The proration does not apply to the tray fees which are paid according to the Alberta Schedule of Medical Benefits (SOMB) rules.

Any HSCs not defined in the list of in-basket codes are considered out-of-basket and paid at 100% of the FFS amount. 

Questions or feedback? Physicians and teams can utilize our PCCM General Inquiry Form.

PCPCM In-Basket Service Codes

Visit HSCs   

Description 

Visit HSCs   

03.01AD 

Description 

Diagnostic interview and evaluation, unqualified {Advice to a patient or their agent (agent as defined in the Personal Directives Act) via telephone, secure email or videoconference} 

Visit HSCs   

03.01B 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel weekdays 0700 to 1700 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program.} 

Visit HSCs   

03.01BA 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program.} 

Visit HSCs   

03.01BB 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice provided to community mental health care workers, child protection workers, group home staff, or educational personnel any day 2200 to 0700 hours in relation to the care and treatment of a patient receiving community mental health care services under the Alberta community mental health care program.} 

Visit HSCs   

03.01C 

Description 

Diagnostic interview and evaluation, unqualified {Telehealth assistance service} 

Visit HSCs   

03.01CC 

Description 

Telephone advice and counselling to a patient or their agent (agent as defined in the Personal Directives Act) regarding the COVID-19 vaccine 

Visit HSCs   

03.01LG 

Description 

Diagnostic interview and evaluation, unqualified {Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, weekdays 0700 to 1700 hours} 

Visit HSCs   

03.01LH 

Description 

Diagnostic interview and evaluation, unqualified {Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours} 

Visit HSCs   

03.01LI 

Description 

Diagnostic interview and evaluation, unqualified {Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, any day 2200 to 0700 hours} 

Visit HSCs   

03.01LJ 

Description 

Diagnostic interview and evaluation, unqualified {Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, weekdays 0700 to 1700 hours} 

Visit HSCs   

03.01LK 

Description 

Diagnostic interview and evaluation, unqualified {Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours} 

Visit HSCs   

03.01LL 

Description 

Diagnostic interview and evaluation, unqualified {Physician, nurse practitioner, midwife or podiatric surgeon to physician telephone or telehealth videoconference or secure videoconference consultation, consultant, any day 2200 to 0700 hours} 

Visit HSCs   

03.01N 

Description 

Diagnostic interview and evaluation, unqualified {Management of anticoagulant therapy to include ordering necessary blood tests, interpreting results, adjusting the anticoagulant dosage as required} 

Visit HSCs   

03.01NG 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse weekdays 0700 to 1700 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient} 

Visit HSCs   

03.01NH 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse weekdays 1700 to 2200 hours, weekends and statutory holidays, 0700 to 2200 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient} 

Visit HSCs   

03.01NI 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice to paramedic - pre hospital patch, Mobile Integrated Healthcare Unit paramedic, assisted living/designated assisted living and lodge staff, active treatment facility worker for hospital in-patient, long term care worker for patients in a long term care facility, nurse practitioner, hospice worker, home care worker, midwife or public health nurse any day 2200 to 0700 hours, provided via telephone or other telecommunication methods, in relation to the care and treatment of a patient} 

Visit HSCs   

03.01NM 

Description 

Diagnostic interview and evaluation, unqualified {Patient care advice to a pharmacist provided via telephone or other telecommunication methods in relation to the care and treatment of a patient} 

Visit HSCs   

03.01O 

Description 

Diagnostic interview and evaluation, unqualified {Physician or Nurse Practitioner to Physician secure E-Consultation, consultant} 

Visit HSCs   

03.01R 

Description 

Diagnostic interview and evaluation, unqualified {Physician to Physician secure E-Consultation, referring physician} 

Visit HSCs   

03.01S 

Description 

Diagnostic interview and evaluation, unqualified {Physician to patient secure electronic communication} 

Visit HSCs   

03.01T 

Description 

Diagnostic interview and evaluation, unqualified {Physician to patient secure videoconference} 

Visit HSCs   

03.02A 

Description 

Diagnostic interview and evaluation, described as brief {Brief assessment of a patient's condition requiring a minimal history with little or no physical examination} 

Visit HSCs   

03.03A 

Description 

Diagnostic interview and evaluation, described as limited {Limited assessment of a patient's condition requiring a history related to the presenting problems, an examination of the relevant body systems, appropriate records, and advice to the patient - in office.} 

Visit HSCs   

03.03B 

Description 

Diagnostic interview and evaluation, described as limited {Prenatal visit - in office.} 

Visit HSCs   

03.03C 

Description 

Diagnostic interview and evaluation, described as limited {Routine post-natal office examination} 

Visit HSCs   

03.03CV 

Description 

Diagnostic interview and evaluation, described as limited {Assessment of a patient's condition via telephone or secure videoconference.} 

Visit HSCs   

03.03N 

Description 

Diagnostic interview and evaluation, described as limited {Home visit - first patient} <<Home Visits>> 

Visit HSCs   

03.03P 

Description 

Diagnostic interview and evaluation, described as limited {Home visit - second/subsequent patients} 

Visit HSCs   

03.04A 

Description 

Diagnostic interview and evaluation, described as comprehensive {Comprehensive assessment of a patient's condition requiring a complete history, a complete physical examination appropriate to the physician's specialty, an appropriate record and advice to the patient - in office.} 

Visit HSCs   

03.04B 

Description 

Diagnostic interview and evaluation, described as comprehensive {Initial prenatal visit requiring complete history and physical examination} 

Visit HSCs   

03.04I 

Description 

Diagnostic interview and evaluation, described as comprehensive {Comprehensive visit, including completion of form, required for admission to a regional health authority addiction residential treatment centre} 

Visit HSCs   

03.04K 

Description 

Diagnostic interview and evaluation, described as comprehensive {Comprehensive geriatric assessment, first full 90 minutes} 

Visit HSCs   

03.04M 

Description 

Diagnostic interview and evaluation, described as comprehensive {Pre-operative history and physical examination in relation to an insured service} 

Visit HSCs   

03.04N 

Description 

Diagnostic interview and evaluation, described as comprehensive {Comprehensive evaluation including completion of forms to determine capacity as defined by the Personal Directives Act (PDA) (RSA 2007 s9(2)(a))} 

Visit HSCs   

03.04Q 

Description 

Diagnostic interview and evaluation, described as comprehensive {Post surgical cancer surveillance examination} 

Visit HSCs   

03.05I 

Description 

Other diagnostic interview and evaluation {Direct care, reassessment, education and/or general counselling of a patient requiring palliative care, per 15 minutes or portion thereof - in office or a patient's home} 

Visit HSCs   

03.05JA 

Description 

Other diagnostic interview and evaluation {Formal, scheduled, multiple health discipline team conference, full 15 minutes or major portion thereof for the first call when only one call is claimed} <With para-medical personnel regarding the provision of health care where social and other issues are involved> 

Visit HSCs   

03.05JB 

Description 

Other diagnostic interview and evaluation {Formal, scheduled family conference relating to a specific patient, per 15 minutes or major portion thereof} 

Visit HSCs   

03.05JH 

Description 

Other diagnostic interview and evaluation {Family conference via telephone, in regards to a community patient} 

Visit HSCs   

03.05JN 

Description 

Other diagnostic interview and evaluation {Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of multiple patients undergoing rehabilitation therapy including those with chronic pain, when discussion occurs on behalf of a specific patient per full 5 minutes to a maximum of 6 units in a 30 minute period} 

Visit HSCs   

03.05JQ 

Description 

Other diagnostic interview and evaluation {Family conference with relative(s) via telephone in connection with the management of a patient with a psychiatric disorder} 

Visit HSCs   

03.05JR 

Description 

Other diagnostic interview and evaluation {Physician telephone call directly to patient, to discuss patient management/diagnostic test results} 

Visit HSCs   

03.05LA 

Description 

Other diagnostic interview and evaluation {Group session, multiple patients, where a physician is involved in providing care and teaching to patients in attendance} 

Visit HSCs   

03.05O 

Description 

Other diagnostic interview and evaluation {Direct management, reassessment, education and/or general counselling of a patient with chronic pain, per 15 minutes or portion thereof} 

Visit HSCs   

03.05T 

Description 

Other diagnostic interview and evaluation {Formal, scheduled, professional interview relating to the care and treatment of a palliative care patient with other physicians, family, and/or direct therapeutic supervision of allied health professionals or community agencies, on behalf of a specific patient, full 15 minutes or major portion thereof for the first call when only one call is claimed} 

Visit HSCs   

03.05U 

Description 

Other diagnostic interview and evaluation {Second and subsequent physician attendance at formal, scheduled, professional interview relating to the care and treatment of a palliative care patient with other physicians, family and/or direct therapeutic supervision of allied health professionals or community agencies, on behalf of a specific patient, full 15 minutes or major portion thereof for the first call when only one call is claimed} 

Visit HSCs   

03.05V 

Description 

Other diagnostic interview and evaluation {Formal, scheduled, professional interview relating to the care and treatment of a patient with chronic pain with other physicians, and/or direct therapeutic supervision of allied health professionals or community agencies, on behalf of a specific patient, per 15 minutes} 

Visit HSCs   

03.05X 

Description 

Other diagnostic interview and evaluation {Formal, scheduled, professional interview with relative(s) relating to the care and treatment of a patient with chronic pain on behalf of a specific patient, full 15 minutes or major portion thereof for the first call when only one call is claimed} 

Visit HSCs   

03.07A 

Description 

Consultation, described as limited {Minor consultation - in office} 

Visit HSCs   

03.07B 

Description 

Consultation, described as limited {Repeat consultation} 

Visit HSCs   

03.08A 

Description 

Consultation, described as comprehensive {Comprehensive consultation - in office} 

Visit HSCs   

03.08CV 

Description 

Consultation, described as comprehensive {Comprehensive consultation via telephone or secure videoconference} 

Visit HSCs   

03.08F 

Description 

Consultation, described as comprehensive {Formal, comprehensive consultation, for a patient with chronic pain, full 60 minutes or major portion thereof for the first call when only one call is claimed} 

Visit HSCs   

07.57B 

Description 

Application of other wound dressing {Subsequent treatment - minor burns - dressing and/or debridement} 

Visit HSCs   

08.19CW 

Description 

Other psychiatric evaluation and interview {Telephone or secure videoconference with a patient for scheduled psychiatric treatment or for a palliative care or a chronic pain visit by an eligible physician, per 15 minutes or major portion thereof.} 

Visit HSCs   

08.19D 

Description 

Other psychiatric evaluation and interview {Professional interview with relative(s) in connection with the management of a patient with a psychiatric disorder, but without the patient being present during the interview, per 15 minutes or major portion thereof} 

Visit HSCs   

08.19F 

Description 

Other psychiatric evaluation and interview {Formal, scheduled, professional conference related to the care and treatment of a psychiatric patient with other physician(s), and/or direct therapeutic supervision of, allied health professionals, educational, correctional and other community agencies on behalf of a specific patient, provided by the physician most responsible for the patient's care, per 15 minutes or major portion thereof} 

Visit HSCs   

08.19G 

Description 

Other psychiatric evaluation and interview {Direct contact with an individual patient for psychiatric treatment (including medical psychotherapy and medication prescription), psychiatric reassessment, patient education and/or general psychiatric counselling, per 15 minutes or major portion thereof - in office.} 

Visit HSCs   

08.19H 

Description 

Other psychiatric evaluation and interview {Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of a psychiatric patient, on behalf of a specific patient, per 15 minutes or major portion thereof} 

Visit HSCs   

08.19J 

Description 

Other psychiatric evaluation and interview {Formal, scheduled, professional conference related to the care and treatment of multiple psychiatric patients with other physician(s), allied health professionals, educational, correctional and other community agencies on behalf of a specific patient, provided by the physician most responsible for the patient's care} 

Visit HSCs   

08.19K 

Description 

Other psychiatric evaluation and interview {Second and subsequent physician attendance at a formal, scheduled, professional conference related to the care and treatment of multiple psychiatric patients, when discussion occurs on behalf of a specific patient} 

Visit HSCs   

08.44A 

Description 

Group therapy {Group psychotherapy, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed} 

Visit HSCs   

08.45 

Description 

Family therapy {Assessment or therapy of a family, requiring comprehensive psychiatric or family systems evaluation, first full 45 minutes or major portion thereof for the first call when only one call is claimed - in office.} 

Visit HSCs   

13.59V 

Description 

Immunization and administration of COVID-19 vaccine 

Visit HSCs   

13.59VA 

Description 

Prolonged COVID-19 vaccination - physician time only, greater than 10 minutes 

Visit HSCs   

13.82A 

Description 

Ultraviolet light therapy {Psoralen ultraviolet A treatment, ultraviolet B or narrow-band ultraviolet B treatment} 

Visit HSCs   

13.99J 

Description 

Other diagnostic interview and evaluation {Medical emergency detention time, per 15 minutes} 

Visit HSCs   

98.12S 

Description 

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Non surgical treatment, cryotherapy} <<Condylomata acuminata>> 

 

PCPCM In-Basket Procedure Codes

Procedure HSCs    

Description   

Procedure HSCs    

03.12A   

Description   

Measurements and manual examination of nervous system and sense organs {Intraocular pressure measurement, unilateral or bilateral}   

Procedure HSCs    

07.57A   

Description   

Application of other wound dressing {Initial treatment - minor burn}   

Procedure HSCs    

10.16B   

Description   

Insertion of other vaginal pessary {Pessary removal, adjustment and/or reinsertion}   

Procedure HSCs    

11.71A   

Description   

Removal of intrauterine contraceptive device (IUD) {Removal of intrauterine contraceptive device (IUD)}   

Procedure HSCs    

12.21   

Description   

Removal of intraluminal foreign body from ear without incision   

Procedure HSCs    

13.42A   

Description   

Immunization for allergy {Desensitization treatments with allergy serums}   

Procedure HSCs    

13.53B   

Description   

Injection of steroid {Intralesional injection(s) of steroid}   

Procedure HSCs    

13.59A   

Description   

Injection or infusion of other therapeutic or prophylactic substance nec {Intramuscular or subcutaneous injections}   

Procedure HSCs    

13.59J   

Description   

Injection or infusion of therapeutic or prophylactic substance NEC {Injection with local anesthetic of myofascial trigger points}   

Procedure HSCs    

13.59O   

Description   

Injection or infusion of therapeutic or prophylactic substance NEC {Injections of Botulinum A Toxin for the prophylaxis of chronic migraine headaches for eligible patients 18-65 years of age}   

Procedure HSCs    

13.99BA   

Description   

Other miscellaneous diagnostic and therapeutic procedures NEC {Periodic Papanicolaou Smear for patients between the ages of 21 and 69}   

Procedure HSCs    

13.99BE   

Description   

Other miscellaneous diagnostic and therapeutic procedures NEC {Pelvic examination using a speculum requiring swab(s) and/or sample(s) collection}   

Procedure HSCs    

17.71A   

Description   

Peripheral nerve injection, unqualified {Local block(s) of somatic nerve(s)}   

Procedure HSCs    

37.91A   

Description   

Lingual frenotomy {Release of simple tongue tie, clipping}   

Procedure HSCs    

51.92A   

Description   

Injection of sclerosing agent or solution into vein {Varicose vein, single injection}   

Procedure HSCs    

51.92B   

Description   

Injection of sclerosing agent or solution into vein {Varicose vein, additional injection}   

Procedure HSCs    

80.83B   

Description   

Uterine biopsy {Endometrial biopsy}   

Procedure HSCs    

81.8   

Description   

Insertion of intra-uterine contraceptive device   

Procedure HSCs    

93.91A   

Description   

Arthrocentesis {Joint aspiration, injection, hip}   

Procedure HSCs    

93.91B   

Description   

Arthrocentesis {Joint aspiration, injection, other joints}   

Procedure HSCs    

95.93   

Description   

Injection/aspiration of therapeutic substance into bursa <Subacromial>   

Procedure HSCs    

95.94A   

Description   

Injection of therapeutic substance into other soft tissue {Injection with local anesthetic of myofascial trigger points combined with a spray and stretch technique}   

Procedure HSCs    

95.96A   

Description   

Aspiration of other soft tissue {Other bursae, tendon sheaths, ganglion of wrist or ankle, aspiration, injection}   

Procedure HSCs    

98.01A   

Description   

Tattooing or insertion into skin and subcutaneous tissue {Implantation of subdermal contraceptive implant}   

Procedure HSCs    

98.03A   

Description   

Other incision with drainage of skin and subcutaneous tissue {Incision and drainage of abscess or hematoma, subcutaneous or submucous}   

Procedure HSCs    

98.04B   

Description   

Incision with removal of foreign body of skin and subcutaneous tissue {Incision with removal of foreign body of skin and subcutaneous tissue without anesthesia}   

Procedure HSCs    

98.11A   

Description   

Debridement of wound or infected tissue {Non-functional area, up to 32 total square cms}   

Procedure HSCs    

98.11D   

Description   

Debridement of wound or infected tissue {Functional area, up to 32 total square cms}   

Procedure HSCs    

98.12A   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Excisional biopsy, skin}   

Procedure HSCs    

98.12B   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Excisional biopsy, skin of face}   

Procedure HSCs    

98.12C   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal of sebaceous cyst}   

Procedure HSCs    

98.12H   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Excision of soft tissue tumor(s) (subcutaneous) full 30 minutes of operating time or major portion thereof for the first call when only one call is claimed}   

Procedure HSCs    

98.12J   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal or excision, first lesion}   

Procedure HSCs    

98.12K   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal by fulguration, first lesion}   

Procedure HSCs    

98.12L   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Non-surgical treatment (cryotherapy, chemotherapy), warts or keratoses}   

Procedure HSCs    

98.12M   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal of pigmented benign nevus, excluding face}   

Procedure HSCs    

98.12N   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal of pigmented benign nevus of the face}   

Procedure HSCs    

98.12Q   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal of any atypical or neoplastic lesion(s) - any method excluding cryotherapy for actinic keratoses} <<Multiple dysplastic or localized carcinomatous lesions of the skin>>   

Procedure HSCs    

98.12R   

Description   

Local excision or destruction of lesion or tissue of skin and subcutaneous tissue {Removal of first plantar wart}   

Procedure HSCs    

98.22A   

Description   

Suture of skin and subcutaneous tissue of other sites {Laceration, face, up to 2.5 cms (1 unit) or body, up to 5 cms (1 unit)}   

Procedure HSCs    

98.22B   

Description   

Suture of skin and subcutaneous tissue of other sites {Laceration, face, over 2.5 cms (1 unit) and/or body, over 5 cms (1 unit)} <For each layer or unit, refer to Price List>   

Procedure HSCs    

98.81A   

Description   

Biopsy of skin and subcutaneous tissue {Biopsy, skin}   

Procedure HSCs    

98.81B   

Description   

Biopsy of skin and subcutaneous tissue {Punch biopsy}   

Procedure HSCs    

98.96A   

Description   

Removal of nail, nailbed or nailfold {Wedge excision}   

Procedure HSCs    

98.99AA   

Description   

Other operations on skin and subcutaneous tissue NEC {Acne surgery}<For incision and drainage and/or cryotherapy of cysts; and superficial peels for acne including liquid nitrogen and glycolic peels>