When can I bill the extended visit, tariff 8640, in Manitoba?
Bill tariff ~8640 (Extended Visit) in Manitoba when you assess two or more distinct complaints or problems in one visit and the visit takes a minimum of 20 minutes of physician time. It pays $70.00 (Manitoba Physician's Manual, page A-120). The tilde (~) means it is a provisional tariff. Rule 56 asks for a descriptive report that gives the length of the visit with every claim for it (page Rules-12).
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
Fee box
| Tariff | Description | Fee | Manual page | Manual dated |
|---|---|---|---|---|
| ~8640 | Extended visit (provisional): two or more distinct complaints, a minimum of 20 minutes of physician time | $70.00 | A-120 |
When it applies
- “An extended visit is to assess two or more distinct complaints or problems from the patient” (A-120).
- It “shall be comprised of”: “A history of the presenting two or more complaints”; “An examination of the parts or systems related to the presenting complaints”; “A review of all pertinent investigations”; and “A complete written record and advice to the patient”. (A-120)
- “The visit shall be a minimum of twenty (20) minutes of physician time.” (A-120)
- The tilde (~) marks a provisional tariff. The manual says it is under evaluation for no more than 18 months from its effective date. The manual does not give that date. The same Rules of Application apply as for permanent tariffs. A descriptive report, “including the length of time for the procedure or service, must be submitted with any claim for a provisional tariff.” (Rules-12) The manual's claims section adds “except as otherwise agreed to by Manitoba Health and Doctors Manitoba” (CLMST-2). The manual does not say whether such an agreement covers ~8640.
- “If applicable, an age premium will automatically be applied to tariff ~8640.” (A-120) The premium is 10% for patients aged 65 to 69 and 20% for patients 70 or older. (A-119) Manitoba Health adds it. It is not a separate line on the claim.
When it does not apply
- One complaint, or less than 20 minutes of physician time. Look at 8529 or 8509 instead. (A-119 to A-120)
- A video visit. The video tariff is ~8350, and its claim must include start and stop times. (A-121 to A-122)
What the manual does not say
- The manual does not define “distinct”. When two complaints are closely linked, ask Manitoba Health how to claim.
- Rule 6: within 60 days of a complete or regional history and examination by the same physician for the same condition, “only a subsequent visit may be claimed”. One example is a chronic illness that needs a more extensive examination within the 60 days. A claim for that visit “may be allowed but only by Special Report”. The manual does not say whether ~8640 counts as a subsequent visit. (Rules-2)
When another tariff fits better
| Tariff | Description | Fee | Manual page | Manual dated |
|---|---|---|---|---|
| 8529 | Regional intermediate visit: a problem-specific assessment, a minimum of 10 minutes or “the patient is over 65 years of age” | $41.02 | A-119 | |
| 8509 | Regional basic visit: generally less than 10 minutes of physician time | $29.28 | A-120 | |
| 8540 | Complete history and physical examination | $93.66 | A-119 | |
| ~8350 | Extended virtual visit by video (provisional): two or more distinct complaints, a minimum of 20 minutes | $70.00 | A-121 |
Worked example
A 58-year-old patient comes in with a new rash on the arm and also describes new heartburn. You take a history of both, examine the related systems, review recent results and advise on each. The visit takes 24 minutes of your time. You write the minutes in the note.
Bill ~8640: $70.00. Send the descriptive report with the claim, including the 24 minutes.
Had the same visit taken 15 minutes, 8529 applies: $41.02.
What is often not billed
A visit that covers two or more distinct problems and takes 20 minutes or more of your time is ~8640 ($70.00), not 8529. The minutes decide it. The note should support the four parts on page A-120: a history of the complaints, an examination of the related parts or systems, a review of all pertinent investigations, and a complete written record and advice to the patient. Tip: write down how many minutes the visit took. Rule 56 asks for the length of time in the report sent with the claim. (Rules-12)
Source
Manitoba Physician's Manual, April 1, 2026 edition (with the October 1, 2026 update), pages A-119 to A-122, Rules of Application 6 and 56 (pages Rules-2 and Rules-12), and the claims section (page CLMST-2). Manitoba Health publishes the manual at gov.mb.ca/health/manual.
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
Unbilled is not Manitoba Health or Doctors Manitoba. This page is general information, not a ruling on any claim. Manitoba Health decides what is payable. Check the current manual before you bill.
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