New Changes to Alberta Health Schedule of Medical Benefits | ClinicAid Blog

As of April 1st, 2014, recent changes made to the Alberta Health Care Insurance Plan (AHCIP) Schedule of Medical Benefits will come into effect. These changes will affect some codes, facilities, and pricing rates with codes and facilities being removed or added and pricing amounts being changed.

We have updated ClinicAid with the applicable changes to make as many as possible automated within the software. A quick video walk-through of the changes to ClinicAid's medical billing software has also been created and can be found on our YouTube channel, along with other useful tutorials.

Code Changes

Some of the codes that have changed are as follows:
New Service Codes Available as of April 1st, 2014

• 03.05GA 
• 03.44A 
• 07.54B 
• 09.02D 
• 09.02E

These codes will only be found in the search results if the service date for the code is April 1st or later. Trying to bill for these codes for a service date prior to April 1st will result in an error as we've updated ClinicAid to ensure that the codes are billed accurately.

Service Codes No Longer Available as of April 1st, 2014

• 03.05NT
• 03.05ZF
• 03.05BT
• 03.05XT
• 03.05BP
• 03.05BU
• 03.05VQ

These codes will not be available after March 31st, 2014. Much like the new codes, ClinicAid will check the service date you are trying to bill for in order to ensure that you are billing accurately. If you are trying to use on of these codes for a service date after Mach 31st, you will receive an error when saving the bill.

Changed Fee Modifier

The COMX fee modifier for the 03.03D service code (Hospital visits) has been removed and replaced with the COINPT fee modifier. 

Pricing Changes

Some codes have had their rates adjusted. For example, code 03.03D's base value before April 1st was $33.82. As of April 1st, the new base value for this service code will be $40.58. Around 2500 service codes have been updated with new prices.

Facility Changes

A number of facilities have been removed while new ones have been added to the list of valid facility numbers. Again, these will be available depending on the service date when billing within ClinicAid. 

It is important to make note of these changes in order to ensure you are submitting your bills to AHCIP correctly. For more information and the full details behind the changes, as well as an exhaustive list of new codes, prices, and more, please visit the Alberta Medical Association's Billing Corner and view the PDF version of the new Schedule of Medical Benefits that comes into effect on April 1st, 2014.