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Alberta virtual care billing codes cheat sheet and AHCIP checklist

Key takeaways

Virtual care is here to stay: In Alberta, virtual visits jumped from 4% pre-pandemic to 60%, and billing codes have evolved to support this shift.
AHCIP now includes virtual care codes: Physicians can bill for assessments, consultations, and psychotherapy via phone or video, but strict rules apply.
Compliance matters: Document start/stop times, follow minimum time requirements, and know which codes have limitations to avoid claim reductions.

As technology improves and patient expectations evolve, virtual care is expected to remain a core part of healthcare delivery in Canada. But for physicians in Alberta, one critical question remains: how do you bill for virtual care under AHCIP?

COVID-19 changed healthcare in countless ways, but one of the most lasting shifts has been the rise of virtual care. During the pandemic, many physicians integrated virtual visits into their practice and dedicated virtual care platforms grew rapidly.

Medical billing for virtual care in Alberta: Key changes

Before the pandemic, one of the biggest barriers to virtual care adoption was the limited billing options under Alberta’s public health insurance plan (AHCIP). While challenges remain, Alberta Health has introduced specific virtual care billing codes to make remuneration possible.

In this guide, we’ll break down:

What AHCIP virtual care codes are.
Who can use them.
How much they’re worth.
How to bill correctly.

AHCIP groups virtual care codes into two categories:

Codes without limitations
Codes with limitations (restrictions on how often they can be billed)

Important: Even codes without limitations may still restrict the number of times they can be billed per patient. Let’s review both categories.

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General rules for AHCIP virtual care billing

To keep your billing compliant, Alberta Health requires physicians to follow these rules for most virtual care codes:

Patient-initiated service : The patient (or their agent) must initiate the request. If accommodations are needed, such as scheduling a call, the service can still be claimed.
Physician-provided service only : Virtual codes cannot be billed if another healthcare professional provides the service under physician supervision.
One virtual code per patient per day per physician : For codes like 03.03CV, 03.01AD, 03.01S, 03.01T, 03.03FV, 03.05JR, 03.08CV, 08.19CV, 08.19CW, and 08.19CX, only one can be claimed per patient per day.
Documentation required : Record start and stop times and all service details. Without proper documentation, Alberta Health may reduce the claim to the lowest valued service.
Minimum time requirements : Codes such as 03.03CV, 03.03FV, 03.08CV, 08.19CV, 08.19CW, and 08.19CX require specific time thresholds. Document exact time spent.
Only patient communication counts : Time spent on administrative tasks cannot be claimed.
No complexity modifiers or time premiums : These do not apply to virtual care codes.
Limited-use codes : Codes like 03.05JR, 03.01S, or 03.01T have weekly limits per physician and per patient.
Virtual codes do not count toward daily visit caps : They are classified as “V” visit category codes but do not count toward the 50-visit daily cap.

Alberta virtual codes cheat sheet (without limitations)

Here’s a detailed look at Alberta Health’s virtual billing codes:

03.01AD – Advice to patient or agent

Description: Advice to a patient or their agent via telephone, email and videoconference including virtual care during a viral epidemic.

Value: $20.00

Tips:

Only one per patient per physician per day.

Use the location of the physician at the time of the call for tracking purposes; the diagnostic code that must accompany the claim is 079.82 if it is COVID-19 related.

May not be billed:

When leaving a message.

When the nurse provides the service.

In addition to any other service provided on the same day for the same patient.

If a call is transferred to the physician through Health Link.

03.03CV – Virtual assessment

Description: Assessment provided by General Practitioners (GP) and Specialists via telephone or secure videoconference; 10+ minutes per physician: patient direct time.

Value: Rates vary by skill and will be equal to an in-person limited assessment (HSC 03.03A). Example: $40.23 for GPs.

Tips:

The assessment must last a minimum of 10 minutes. An assessment that does not meet the minimum requirements or is less than 10 minutes must be claimed using 03.01AD.

Benefit includes the ordering of appropriate diagnostic tests and procedures as well as discussion with the patient.

03.03FV – Specialist follow-up

Description: Follow up assessments (visits), for referred patients only, provided by specialists via telephone or secure videoconference; 10+ minutes per physician: patient direct time.

Restrictions: Specific specialties only.

Value: Rates will be equal to an in-person follow-up assessment (HSC 03.03F) and vary by skill. Example: $104.16 for pediatrics.

Tips:

“Referred patients” means the patient was initially referred to a physician and the physician is continuing to care for the patient and their condition.

The service must last 10 or more minutes; if less than 10 minutes, bill 03.01AD

03.03FA, complex modifiers, or time premiums are not billable in addition to this service.

03.08CV – Comprehensive consultation

Description: Comprehensive consultations provided via telephone or secure videoconference; consultation requirements apply.

Value: Rates vary by skill and will be equal to an in-person comprehensive consultation (HSC 03.08A). Example: $131.40 for GPs.

Tips:

Patient must be referred.

Surcharge modifiers and time premium are not billable in addition to this service.

08.19CX – Psychiatric consultation

Description: Comprehensive psychiatric consultation provided via telephone or secure videoconference; consultation requirements apply.

Restrictions: May only be claimed by a psychiatrist (PSYC) or a generalist in Mental Health (GNMH).

Value: Rates vary by skill and will be equal to an in-person psychiatric consultation (HSC 08.19A). Example: $189.58 for Psychiatry.

Tips:

Patient must be referred.

Only billable by PSYC and GNMH.

Surcharge modifiers and time premiums are not billable in addition to this service.

08.19CV – Psychotherapy and psychiatric services

Description: Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a psychiatrist or a generalist in mental health.

Restrictions: May only be claimed by a psychiatrist (PSYC), a generalist in mental health (GNMH), or by a specialist in mental health (SPMH).

Value: Rates will vary by skill and be equal to an in-person psychiatric assessment (HSC 08.19GA). Example: $61.46 for Psychiatry.

Tips:

Patients must be referred.

Only billable by PSYC, GNMH, or SPMH.

Surcharge modifiers and time premiums are not billable in addition to this service.

08.19CW – Psychotherapy for GPs and pediatricians

Description: Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a GP or pediatrician per full 15 minutes.

Restrictions: May only be claimed by a GP, a pediatrician, or any qualified physician for palliative care or chronic pain.

Value: Rates vary by skill and will be equal to an in-person psychiatric assessment (HSC 08.19G). Example: $50.28 for GPs.

Tips:

Virtual group therapy to be claimed using this HSC. Choose one patient and claim the total time providing group therapy under the one patient’s PHN.

Time premiums are not billable in addition to this service.

For treatment of non-scheduled psychiatric treatment, the appropriate office visit health service code should be claimed (03.03CV).

Alberta virtual codes cheat sheet (with limitations)

Some virtual care codes have strict usage limits. Here’s what you need to know:

03.05JR – Physician phone call for test results

Description: Physician telephone call directly to patient to discuss test results; maximum of 14 per week per physician.

Value: $20.00

Tips:

03.05JR may be claimed when speaking with:

The parent or guardian of a pediatric patient.

The primary caregiver of a patient with mental health concerns.

An agent as defined by the Personal Directives Act.

03.05JR may not be claimed when the physician leaves a message for the patient.

Alberta Health’s payment system requires different encounter numbers for 03.05JR and a visit item when they are provided on the same date of service. For example, if you provide both services on the same day, then you add a separate encounter number for the visit (encounter 1) and the 03.05JR (encounter 2). This is an exception as phone calls do not ordinarily need an encounter number.

May not be claimed for management of a patient’s anticoagulant therapy (billable under HSC 03.01N).

May be claimed in addition to visits or other services provided on the same day, by the same physician.

Neither HSCs 03.01S or 03.01T are payable if HSC 03.05JR is claimed in the same calendar week by the same physician for the same patient.

03.01S – Secure email communication

Description: Physician to patient secure electronic communication; maximum one per patient per week up to a maximum of 14 per week per physician.

Value: $20.00

Tips:

May only be claimed once per week per patient per physician.

A visit service may not be claimed if provided within 24 hours following the electronic communication.

May not be claimed for inpatients.

HSC 03.01S is not payable in the same calendar week as 03.05JR or 03.01T by the same physician for the same patient.

May only be claimed for those patients where an established physician-patient relationship exists and the physician saw the patient in the previous 12 months.

03.01S may only be claimed once per patient per week regardless of the number of email exchanges occurring in the week with the same patient. This service may only be claimed when a response prepared by the physician is provided to the patient. This code is not to be claimed for receiving an email and proceeding to call the patient for a face-to-face visit.

May only be claimed when the service is provided using a secure email system that follows the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta.

03.01T – Secure videoconference

Description: Physician to patient secure videoconference; maximum one per patient per week up to a maximum of 14 per week per physician.

Value: $20.00

Tips:

May only be claimed once per week per patient per physician.

HSC 03.01T is not payable in the same calendar week as 03.05JR or 03.01S by the same physician for the same patient.

May not be claimed for inpatients.

May only be claimed for those patients where an established physician-patient relationship exists and the physician saw the patient in the previous 12 months.

May only be claimed when the service is provided using a secure videoconference system that follows the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta.

A visit service may not be claimed if provided within 24 hours following the electronic communication.

Cheat Sheet / Table:

Use this cheat sheet / table to understand virtual care billing codes in Alberta:

Alberta virtual codes cheat sheet (without limitations)

Code	Description	Value	Specialty Restrictions	Billing Restrictions
03.01AD	Advice to patients or their agent via telephone, email, and videoconference.	$20.00	N/A	Maximum one per patient per physician per day.
03.03CV	Assessment provided by General Practitioners (GP) and specialists via telephone or secure videoconference; 10+ minutes per physician: patient direct time.	Rates will be equal to an in-person limited assessment (HSC 03.03A) and vary by skill.	Rate Specific	Assessment must last a minimum of 10 minutes.
03.03FV	Follow up assessments (visits), for referred patients only, provided by specialists via telephone or secure videoconference; 10+ minutes per physician: patient direct time.	Rates will be equal to an in-person follow-up assessment (HSC 03.03F) and vary by skill.	Rate Specific	Service must last a minimum of 10 minutes.
03.08CV	Comprehensive consultations provided via telephone or secure videoconference; consultation requirements apply.	Rates will be equal to an in-person comprehensive consultation (HSC 03.08A) and vary by skill.	Rate Specific	Patient must be referred.
08.19CX	Comprehensive psychiatric consultation provided via telephone or secure videoconference; consultation requirements apply.	Rates will be equal to an in-person psychiatric consultation (HSC 08.19A) and vary by skill.	Psychiatrist (PSYC) or a generalist in mental health (GNMH)	Patient must be referred.
08.19CV	Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a psychiatrist or a generalist in mental health.	Rates will be equal to an in-person psychiatric assessment (HSC 08.19GA) and vary by skill.	Psychiatrist (PSYC), a generalist in mental health (GNMH), or a specialist in mental health (SPMH)	Patient must be referred.
08.19CW	Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a GP or pediatrician, per full 15 minutes.	Rates will be equal to an in-person psychiatric assessment (HSC 08.19G) and vary by skill.	GP, pediatrician, or any qualified physician for palliative care or chronic pain	Call-based; per 15 minutes.

Alberta virtual codes cheat sheet (with limitations)

Code	Description	Value	Specialty Restrictions	Billing Restrictions
03.05JR	Physician Telephone Call Directly to Patient to Discuss Test Results. Maximum of 14 per week per physician.	$20.00	N/A	Maximum of 14 per week per physician.
03.01S	Physician to patient secure electronic communication; maximum one per patient per week up to a maximum of 14 per week per physician.	$20.00	N/A	Maximum of 14 per week per physician. Maximum once per week per patient per physician.
03.01T	Physician to Patient Secure Videoconference; maximum one per patient per week up to a maximum of 14 per week per physician.	$20.00	N/A	Maximum of 14 per week per physician. Maximum once per week per patient per physician.

Summary: Virtual care billing in Alberta

Virtual care is now a permanent part of healthcare delivery in Canada, and Alberta’s billing codes are evolving to keep pace. Understanding these codes—and their restrictions—is essential for accurate, compliant billing. Use the Alberta Health Care Insurance Plan: Schedule of Medical Benefits to explore further details on care options.

For deeper insights on virtual care trends, check out: