Professional Standards Regarding Virtual Care: Frequently Asked Questions by Physicians

Yes. Physicians licensed in Nova Scotia can deliver virtual care to other jurisdictions in Canada. Physicians will be held to the standards of that jurisdiction, while subject to the regulation of CPSNS.

Yes. Physicians licensed elsewhere in Canada may deliver virtual care to patients in Nova Scotia without having to obtain a Nova Scotia medical licence. Physicians do not have to submit any documentation to the College to do so.

Physicians licensed elsewhere in Canada who deliver virtual care into Nova Scotia will be held to Nova Scotia standards but subject to the regulation of their licensing authority.

Yes. Physicians can do so for short periods of time only in order to accommodate when a physician travels outside of the province. Physicians licensed in Nova Scotia who deliver virtual care to Nova Scotians are subject to the regulation of the College, irrespective of where the physician is located.

Yes. Physicians licensed in Nova Scotia who deliver care into other jurisdictions in Canada will be held to the standards of that jurisdiction, while subject to the regulation of this College.

Virtual Care encompasses all means by which healthcare providers remotely interact with their patients using communications and digital technology. Synchronous virtual care refers to interactions in real-time through telephone or video platforms. Asynchronous virtual care refers to interactions that do not take place in real-time, such as through email or message boards.

Physicians should refer all questions regarding billing to the Nova Scotia Medical Services Insurance (MSI). Billing FAQs provided by MSI, including the 2021 Payment Schedule can be found here.

Physicians licensed in Nova Scotia who deliver virtual care to Nova Scotians are subject to the regulation of the College, irrespective of where the physician is located.

Physicians licensed in Nova Scotia who deliver care into other jurisdictions in Canada will be held to the standards of that jurisdiction, while subject to the regulation of this College.

Physicians licensed elsewhere in Canada who deliver virtual care into Nova Scotia will be held to Nova Scotia standards but subject to the regulation of their licensing authority.

Currently, there is an important distinction to be made between private and publicly insured virtual care. Physicians cannot deliver publicly insured virtual care into Nova Scotia without a Nova Scotia licence. The province requires that publicly insured telemedicine is offered in conjunction with, rather than as an alternative to, in‐person medical care.

• Regulated health professionals can offer publicly funded virtual health services to Nova Scotians if the health professional is licensed to practice in Nova Scotia and is physically present in the province when the virtual health service is provided. In cases where a provider has a physical office location in Nova Scotia close to the border with New Brunswick (e.g. in Amherst) but resides in New Brunswick, virtual care can be provided and billed for when the provider is in New Brunswick.
• Virtual health services delivered to Nova Scotians may only be billed to the MSI Plan if the patient is physically located in Nova Scotia when the virtual health service is provided.

If a physician were to be outside of Nova Scotia for a short time, then the ordering of labs would be the same as if you were in Nova Scotia. It would require privileging with the relevant facility through the relevant health.

Physicians must not prescribe opioids or other controlled medications to patients whom they have not examined in person, or with whom they do not have a longitudinal treating relationship, unless they are in direct communication with another regulated health professional who has examined the patient.  Refills are permitted if an existing longitudinal treating relationship is in place and is done so not an absolute alternative to in-person care.

Physicians are encouraged to review the College’s Professional Standards and Guidelines Regarding Prescribing and Professional Standards Regarding the Initiation of Acute Pain.

Yes, for existing patients only and for short periods of time such as when outside the province on vacation or attending a conference. Physicians must offer virtual care to patients only in conjunction with in-person care, not as an absolute alternative to in-person care.

Physicians are encouraged to review the College’s Professional Standards and Guidelines Regarding Prescribing and Professional Standards Regarding the Initiation of Acute Pain.