Family Physician Payment Model Comparison

The information in this guide is intended to provide a brief overview of three payment model options for family physicians practicing in British Columbia. This is not a comprehensive comparison of all payment model options for family physicians. It cannot be appropriately interpreted without the LFP Payment Schedule, the MSC Payment Schedule, and a physician’s individual NTP contract.

Resources are provided at the end of this guide.

Available models

Longitudinal Family Physician (LFP) Payment Model

The LFP Payment Model (LFP) is a blended payment model that rewards longitudinal family physicians for their time, patient interactions, and panel size and complexity. This payment model recognizes the complexity of longitudinal care, values the time spent with patients, addresses rising costs, acknowledges indirect care and administrative services, and supports physician agency and practice flexibility. LFP is available for new physicians building their panel, or physicians with an existing panel.

New-to-Practice (NTP) Contract

The NTP Contract is a contract option for physicians wanting to build their patient panels and gain experience in an established full service group clinic. It is primarily focused on new graduates, although some experienced physicians may also be eligible. Physicians do not need to be newly graduated from residency; however, there are more incentives if they are.

Fee-for-Service (FFS)

In Fee-for-Service (FFS), physicians are compensated for the specific service provided. It is the most common form of physician payment in BC and worldwide. It may be a good fit for family physicians providing high-volume services, specialized care, consultative care, and/or facility-based care, as well as physicians providing longitudinal family medicine services or episodic/focused practice services.

What is the best payment model for me?

For family physicians in British Columbia, the best payment model depends on individual preferences and practice needs. Physicians must ensure they meet the contract deliverables (NTP contract) or eligibility criteria (LFP Payment Model) for their chosen payment model. Some factors to consider include patient panel size, time commitment, volume of patient interactions, and compensation structure.

Physicians are responsible for all billing claims submitted under their MSP Practitioner Number.

	Longitudinal Family Physician (LFP)	New-to-Practice (NTP)	Fee-for-Service (FFS)
Must provide Longitudinal Family Physician Services	Yes	Yes	No
Locations	Must have a clinic-based practice. Also available in facility-based settings for Inpatient, LTC/Palliative, and Pregnancy and Newborn services.	Clinic-based only, must bill under another payment model for other locations.	No restrictions to specific locations.
Contract	No	Yes	No
Compensation Structure	Compensated for time, patient interactions, and patient panel.	Contract payments plus overhead payment and conditional bonuses.	Compensated for each service provided.
Hourly requirement	Must provide clinic-based services one day a week.	Minimum .5 FTE	No
Compensated per patient interaction	Yes	Yes (included in contract payments)	Yes
Compensated for time	Yes	Yes (included in contract payments)	No
Compensated for panel size and complexity	Yes	Incentive for meeting attached panel targets. No payment for patient complexity.	No*
Minimum patient panel size	Yes (250 patients within 4 months of enrolling)	Yes (Dependent on contract and FTE)	No*
Restrictions around attached patient panel	Cannot provide more than 30% clinic non-panel services (may not be a good fit for episodic/focused practices).	Services to patients not attached to the practice or in different facilities and clinics must be billed under another payment model.	No

*Physicians who meet the eligibility criteria to submit the CLFP Portal code 14070 may be eligible to claim FPSC-created fees and the CLFP Payment, a quarterly payment to compensate physicians for the size and complexity of their patient panel. This includes having a minimum of 250 empaneled patients.

Additional information

	Longitudinal Family Physician (LFP)	New-to-Practice (NTP)	Fee-for-Service (FFS)
Eligibility*	Provide longitudinal family physician services. Have a minimum of 250 patients within four months of enrolling. Contribute to rent/lease or ownership costs as well as operating costs. Not provide more than 30% clinic non-panel services to patients not on the physician’s panel or panel of another FP/NP at the same clinic.	Provide community longitudinal family physician services. Do not have an established patient panel (some exceptions exist). Must join a full-service group clinic. Commit to a minimum of 0.5 Full Time Equivalent (FTE).	No specific eligibility criteria to bill FFS. Longitudinal physicians who meet the eligibility criteria to bill the CLFP Portal Code 14070 can access FPSC-created fees and payments.
Compensation structure	Time: Compensation for direct/indirect patient care, travel, and clinical administrative time. Patient Interactions: Payment per interaction (e.g., in-person, virtual, procedures, consultations, etc.) Panel Size/Complexity: Compensation based on patient panel size and complexity.	Offers $312,231 NTP Contract rate. Hourly rate varies on FTE definition. Includes $23,158 annually per FTE in conditional bonuses, $75,000 for overhead, and potential additional benefits like a signing bonus. Eligible for loan forgiveness programs for recent graduates.	Traditional model: Physicians are paid for each service or procedure provided. Additional FPSC-created fee codes and payments available to physicians eligible to bill CLFP Portal Code 14070. This includes CLFP Payment that compensates physicians for their patient panel size and complexity.
Benefits	Recognizes the complexity of longitudinal care. Acknowledges indirect care and administrative services. Supports physician agency and practice flexibility.	Provides safety net and financial support for new graduates as they build their practice. Payment amount is consistent and predictable. Simpler billing structure compared to LFP and FFS.	Payments are linked to services provided, offering practice flexibility and potentially higher compensation for high-volume physicians.
Considerations	New payment model—evolving, not covering all settings (e.g., ER, ICU, outpatient clinics); limited fit for focused practices due to non-panel service caps.	Contract—potential limitations as there is a term expected to be fulfilled. Unpredictable if the contract will continue to be offered.	No compensation for time. Income variability. Potential for under-compensation for complex or time-consuming services.
How to enrol	Eligible physicians must complete the LFP enrolment process by submitting the LFP Enrolment Code and applicable Setting Registration Codes via MSP/Teleplan.	Contact your local PCN manager, Division of Family Practice or Health Authority for contract offerings. Contact Negotiations at Doctors of BC for enrolment support.	No enrolment needed. Physicians can start billing per the MSC Payment Schedule. Eligible physicians should submit the CLFP Portal code 14070 annually

*Not an inclusive list of all eligibility requirements. Please refer to the LFP Payment Schedule, MSC Payment Schedule, or your NTP Contract offering.

Resources

Doctors of BC

Payment schedules

Payment model information and resources

Email support

BC Family Doctors

Ministry of Health