Referring Practitioner Information
As of October 1, 2018, requests related to revision of Referring Practitioner Schedules of Benefits and revision of Standard Outpatient Laboratory Requisitions are processed by BC’s Agency for Pathology and Laboratory Medicine at www.bcaplm.ca.
Under the Laboratory Services Act and the Laboratory Services Regulation, approved laboratory facilities may only accept a request from a referring practitioner for a patient (beneficiary) to receive laboratory services (benefits). Under the Laboratory Services Act, a “referring practitioner” means:
- a person enrolled under section 13 of the Medicare Protection Act who makes a request for a beneficiary to receive benefits and is a medical practitioner, midwife, nurse practitioner, dentist, or podiatrist, or a registered nurse (certified).
A laboratory service is a benefit if it is a medically required service provided through an approved laboratory facility by or under the supervision of a laboratory medicine physician who is acting at the request of a referring practitioner.
The minister may establish and adopt guidelines and protocols to guide referring practitioners with respect to referrals for benefits. A referring practitioner must consider all relevant guidelines and protocols when considering the laboratory services for which a beneficiary will be referred.
The Minister of Health has adopted by reference, applicable guidelines and protocols found in the Guidelines and Protocols Advisory Committee (GPAC) clinical practice guidelines.
The GPAC is an advisory committee to the Medical Services Commission and has representatives from both the Doctors of BC and the Ministry of Health.
A referring practitioner must not refer a beneficiary to an approved laboratory facility in which the referring practitioner has a material or indirect financial interest unless there is no public laboratory facility that:
- is in the same catchment area as the approved laboratory facility, and
- provides the benefit.
In certain rural or remote communities, it may not be possible for the beneficiary to attend at an approved laboratory facility in which the referring practitioner does not have a financial or other interest; in these situations, prior written consent of the minister can be requested to permit referrals.
A referring practitioner may submit a request for any benefit (laboratory service or test) subject to any limitations or conditions.
Examples of limits and conditions may include, but are not limited to:
- a laboratory service may only be ordered by a prescribed medical specialty (e.g. Rheumatologist or Internal Medicine Specialist);
- a specific laboratory service may require discussion with a laboratory physician;
- the test or procedure may only be available in certain laboratory facilities or hospitals;
- there may be limits on the frequency of testing (e.g. annual maximum per patient);
- the test is not intended as a diagnostic screening tool; or
- the test may include age limitations for beneficiaries.
Referring practitioners should refer to the full laboratory services schedule of fees for a comprehensive list of outpatient laboratory tests and for additional fee item detail, including notations where add-on tests may be conducted by the laboratory facility or their respective prescribed schedules.