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Moving Facilities Under PCPCM

A practical guide for PCPCM participating physicians who are moving facilities and wish to continue practicing under the PCPCM at the new location

This resource outlines how to notify the Minister, maintain eligibility and keep panel information accurate during and after the move. 

Who does this apply to?

All physicians participating under the Primary Care Physician Compensation Model (PCPCM) that are planning on moving facilities (clinic locations). 

  • By completing the PCPCM Clinical ARP application form, participating physicians attest to not changing or moving from the identified facility(ies) for their PCPCM practice within the first three (3) months following their initial onboarding date.
  • If Physicians plan to enroll in PCPCM and anticipate changing facilities within the next 90 calendar days, wait until establishment at the new clinic before initiating enrollment.
  • Following a 3-month period after claims submission has begun under PCPCM, physicians may change facility locations a maximum of one (1) time per rolling 12-month period beginning from the first day of the month the physician began practicing under PCPCM)
  • The Minister must be informed of the facility move a minimum of 30 days prior to beginning service provision at the new facility
  • Where possible, it is important to time facility moves as the effective date at the new facility must be the first day of a given month
  • If a physician moves mid-month, during the interim period they should bill under their Fee-For-Service (FFS) BA

To maintain eligibility in the PCPCM, Physicians must maintain a minimum panel size of 500 patients. Physicians who switch facilities may have panel size inconsistencies if the transition is not properly timed. If the PCPCM CPAR panel falls below 500 patients, Physicians have 90 calendar days to re-build the panel to meet the eligibility minimum or risk removal from the PCPCM.   

Moving to a new facility requires:

  • Submission of the Facility Change Request Form to Primary and Preventative Health Services (PPHS)
  • Forms related to PCPCM enrollment or participation must be digitally completed and submitted to Health PCPCM Form Submission ([email protected])
  • Terminating the PCPCM CPAR panel at the previous facility (Note: CPAR panels are terminated from PCPCM at the last day of a month and connected to PCPCM on the first day of a month)
  • Onboarding to CII/CPAR at the new facility
  • Creating a new PCPCM CPAR panel ID at the new facility

Failing to properly time these steps can interrupt CPAR panel uploads, potentially reducing the panel size to zero. This may disrupt panel payments and jeopardize PCPCM eligibility. 

Considerations for Physicians and Teams 

  • Confirm the EMR at the new facility is fully compliant with CII/CPAR standards. If the EMR is not, physicians must withdraw. 
  • CPAR panels cannot be transferred to the new facility. A new panel needs to be created and built up.  
  • If EMR data needs to be transferred from the previous facility to the new: 
    • EMR data migrations should be planned and scheduled with vendors prior to starting practice at the new facility. 
    • Be aware, this may extend the transition time, risking interruptions to CPAR panel uploads. 
    • Migrated EMR data may cause inaccurate paneling in the new EMR. Physicians should work with their vendor’s team to ensure key CPAR-related data – such as Date of Last Visit, Date Last Verified, and Patient Status (if applicable) – are included in the data migration. 

Suggested Process for Business Arrangement (BA) & Panel Changes  

PCPCM BA Process

  • All changes to the PCPCM Business Arrangement (BA) will always be made effective on the first of a given month
  • Physicians must notify the Minister of intent to move to a new facility by completing, then submitting a “Physician Move to New Facility Request” form PCN14839 to [email protected]

It is recommended that the Ministry be notified 60 calendar days in advance of the intended move date. A minimum notice of at least 30 calendar days is required as per the Ministerial Order, Section 2.3(g).

Form PCN14839 allows the physician to: 

  • Update their accredited claims submitter and mailing address for PCPCM statements
    • Note: If the submitter on the PCPCM BA is not linked to the new facility, any claims submitted from that location will be rejected. 
  • Update the banking information (if the previous facility was assigned as the payee for PCPCM BA)
    • Note: It is the Physician’s responsibility to finalize and reconcile all claims submissions under their PCPCM BA at the previous facility, before billing under the BA at the new facility. 
  • Add the new PCPCM CPAR panel ID# to their PCPCM BA. The effective date should be the first of the month in which you plan to start practicing at that location. Do NOT remove the original CPAR panel ID# from the PCPCM BA. It will be facilitated with form submission. 

Billing Notes: 

After completing these steps, physicians can start making claims with their new PCPCM BA on the first day the PCPCM BA is active at the new facility. 

Note: Physicians risk missing monthly PCPCM Panel payments if their CPAR panel isn't fully set up by the start date. 

CPAR Panel Changes

  1. Set up the New CPAR Panel

    Ask the new facility staff to begin onboarding to CII/CPAR immediately. Ideally, physicians will onboard to CII/CPAR and have the new CPAR panel ID set up before the first day.  
    Physicians or their support staff need to complete and submit:

    1. An electronic Confirmation of Participation form
    2. CPAR Panel Request form
    3. CPAR Access Admin form
    4. CPAR Panel Admin form


    CPAR panels are linked to PCPCM on the first of a given month. If the facility move is scheduled for mid-month, the panel won’t be connected to PCPCM until the start of the following month. Keep this in mind when planning the clinic move.  

    Note: it is fine to have a new CPAR panel setup even if physicians are still practicing at the previous facility. This reduces the risk of gaps in CPAR panel uploads, which may impact PCPCM panel size. 

  2. Manage Overlap between Previous and New Panels

    If patients from the previous facility follow the physician to the new location, both previous and new facility staff should coordinate with each other and with EMR vendors to schedule the transfer of patient records. It is recommended that the list of patients (ideally including Last Validation Date and Date of Last Visit) on the Physician’s panel in the previous EMR is generated to later verify that patients were successfully transferred and properly paneled in the new EMR. 

    Physicians choose the next step based on the status of their new CPAR panel as of the start date at the new facility:  

    a) New CPAR panel is live before their start date, and the facility is actively paneling your patients there: 

    Have the previous facility submit a CPAR Panel Request form to terminate the previous CPAR panel, with the termination effective on your last day. 

     

    b) You do NOT have a CPAR panel setup yet OR the data migration of patient records to the new EMR has not yet occurred 

    AND 

    Most of your patients are following you to the new facility  

    		 Ask the previous facility to maintain your panel until you have the new CPAR panel set up. Once the new facility is able to start paneling your patients in CPAR and the migration of patient records to the new EMR is complete, have the previous clinic terminate the CPAR panel effective immediately by submitting a CPAR Panel Request form.

    c) You do NOT have a CPAR panel setup yet OR the data migration of patient records to the new EMR has not yet occurred

    AND 

    Most of your patients are NOT following you to the new clinic 

    		 You will need to terminate the old CPAR panel effective as of your last day, by submitting a CPAR Panel Request form. This will cause your CPAR and thus PCPCM panel size to drop to zero. You will have 90 calendar days to build your new CPAR panel to 500+ patients, or risk being removed from PCPCM. Ensure the new facility is actively working with the eHealth team to set up your new live CPAR panel as soon as possible. 

  3. Monitor Panel Status

    Physicians should have the Panel Administrator check the CPAR portal monthly to confirm successful uploads and panel sizes until they have exceeded the 500-patient minimum. 

    If the physician’s PCPCM CPAR panel does not meet the eligibility criteria of a minimum 500-patient panel size within 90 calendar days after the move, PCPCM participation may be terminated. Re-enrollment can occur at 12 months post-termination date.

  4. Panel Payments

    Panel payments are based on panel size and complexity at the new facility, not the previous one. As patient panels are rebuilt, the monthly payments will reflect its current size. Payments will increase as the panel grows.

    Remember, Physicians must meet the minimum of 500 patients within 90 calendar days after the move to maintain eligibility.