Telehealth Billing Codes Alberta 2026
— Verified Virtual Visit Guide
Alberta SOMB 2026 has a clear set of phone and video codes. Picking the correct tier — advice vs assessment vs conference — is the single biggest determinant of whether your virtual visits are billed correctly. This guide covers only PDF-verified telehealth codes.
Verified Telehealth Codes — Alberta SOMB 2026
03.03CV is the virtual-care equivalent of an office assessment. It applies when the encounter involves a substantive history, clinical decision-making, and a management plan delivered by telephone or video — not a brief advice interaction.
Any telephone or video encounter with an established patient that includes a focused history, clinical assessment, and a management decision.
Mode of encounter (telephone / video), date, start time, duration, presenting concern, history obtained, assessment, plan.
Treat 03.03CV as your default virtual assessment code. If the encounter was substantive, it is almost always the correct code — not 03.01AD.
03.01AD is the brief advice code. It is appropriate for short interactions such as conveying a lab result, answering a single clinical question, or providing a prescription refill authorization by phone, email, or video — where no full assessment is performed.
Short, discrete communications with the patient that do not involve a full clinical assessment. Think 'message-level' interaction, not 'visit-level'.
Mode, date/time, content of the advice given, and the clinical rationale. One or two sentences is often enough.
Do not use 03.01AD as a catch-all for everything virtual. If you performed a full assessment, 03.03CV applies — choose the code that matches the clinical work actually done.
03.05JR covers a physician-initiated phone call to a patient — typically to follow up on a result, a prescription change, or a safety check — when the interaction does not rise to the level of a full assessment.
Physician calls the patient (not the other way around), the conversation is brief, and it is distinct from a scheduled appointment.
Start time, content of the call, reason for the call, outcome, and any follow-up plan.
03.05JR overlaps conceptually with 03.01AD. Read the SOMB 2026 notes carefully — the correct choice depends on who initiated the contact and the clinical purpose.
03.05JB is billable when the physician conducts a formal conference with the patient and/or family members — in person, by phone, or by video — to discuss complex care decisions, goals of care, or end-of-life planning. Billed per 15 minutes.
A scheduled, structured conference discussing complex clinical decisions with the patient and/or family members. Not a routine follow-up.
Participants (patient, family members present, their relationship to the patient), topics discussed, decisions made, start/end time, and total duration in minutes.
Time is audit-critical for this code. Document exact start and stop times, not just '30 minutes'. Partial 15-minute blocks follow SOMB rounding rules — check the PDF.
Picking the Right Tier — Worked Example
Same patient, three different virtual interactions on three different days. Each one maps to a different verified SOMB code.
Monday — patient calls to ask about a lab result. You review the result, confirm it's normal, give brief reassurance. 3 minutes.
Wednesday — 18-minute video visit for new URTI symptoms. Focused history, assessment of red flags, management plan, prescription sent.
Friday — 30-minute phone conference with patient and adult daughter to discuss goals of care and advance directives. Two 15-minute units.
Fees from Alberta SOMB 2026, effective April 1, 2026. Subject to SOMB rules, limits, and any applicable co-billing restrictions.
Common Telehealth Billing Mistakes
03.01AD is the advice code — it is not appropriate for a 15-minute video visit that included history, assessment, and a management plan. That encounter is 03.03CV. Picking the smaller code leaves revenue on the table and misrepresents the work performed.
Every virtual encounter note must state the modality explicitly: 'Telephone visit' or 'Video visit via [platform]'. Without this, an auditor cannot verify that the code billed matches the encounter type.
Virtual care codes often require time documentation — especially for conference codes like 03.05JB, which is billed per 15 minutes. 'Call started at 14:05, ended at 14:38' is audit-ready; 'long call' is not.
Every billable telehealth encounter requires a clinical note in the patient chart. A billing claim without a corresponding note is an audit liability, regardless of whether the clinical content was legitimate.
Telehealth Documentation Template
TELEHEALTH ENCOUNTER NOTE Date: [Date] Start time: [HH:MM] End time: [HH:MM] Duration: [X] min Mode: [Telephone / Video via [platform]] Consent: Verbal consent obtained for telehealth encounter. Chief Concern: [Patient's presenting issue] History: [Focused Hx obtained by phone/video] Assessment: [Clinical assessment] Plan: [Management plan incl. any Rx, referrals, follow-up] Billing code: [03.01AD / 03.03CV / 03.05JR / 03.05JB] Rationale: [Why this tier — e.g., "Full focused assessment performed → 03.03CV"]
Frequently Asked Questions
Does Alberta Health require a specific telehealth platform for video visits to be billable?
Alberta Health does not mandate a specific video platform for billing purposes — any secure video communication platform that meets CPSA privacy requirements is acceptable. However, consumer platforms like FaceTime or WhatsApp may not meet PIPEDA-equivalent privacy standards for clinical use. Consult CPSA guidance on acceptable telehealth platforms.
Can I bill a telehealth encounter for a new patient I've never seen before?
Generally, an established patient relationship is required for billable telephone encounters. A first-ever telephone encounter with a completely new patient is typically not billable — it would need to progress to an in-person visit to establish the clinical relationship. Exceptions may apply for urgent situations; consult current SOMB guidance.
How do I choose between 03.01AD and 03.03CV?
03.01AD ($20.00) is for brief advice: conveying a result, answering a single question, authorizing a refill. 03.03CV ($40.23) is for a full assessment performed by phone or video — history, clinical decision-making, and a management plan. Match the code to the scope of clinical work actually performed, not to the convenience of the encounter.
The patient cancelled their video connect and we switched to phone — how do I code this?
Bill the encounter based on its final mode. If the completed encounter met the criteria for 03.03CV (a full assessment), bill 03.03CV regardless of whether it was phone or video. Document: 'Encounter intended as video visit — patient unable to connect, completed by telephone.'
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