The ICBC Fee Schedule Breakdown: Exactly What You Can Bill by Discipline
You probably already know ICBC has a fee schedule. What you might not be tracking as closely: it changes every April 1st, and if you're working from memory or last year's notes, you might be leaving money on the table.
Let me walk you through what you can actually bill, how it works, and the stuff that matters for your practice's bottom line.
The Current ICBC Fee Schedule (As of April 1, 2025)
| Service | Assessment | Standard Session |
|---|---|---|
| Physiotherapy | $151 | $95 |
| Chiropractic | $121 | $75 |
| RMT (Massage) | $128 | $105 |
| Kinesiology | $117 | $94 |
| Counselling | $262 | $157 |
| Psychology | $723 | $241 |
| Acupuncture | $132 | $113 |
Important: These are the maximum amounts ICBC will reimburse. You can charge your patient more—that's between you, your clinic and your patient—but ICBC only covers up to these amounts.
Most multidisciplinary clinics set their ICBC rates at or slightly below these limits for direct billing. If you're charging $120 for a massage session and ICBC reimburses $105, the patient's out-of-pocket difference stays minimal. That's good for your reputation, great for practice growth, and genuinely helps with patient compliance.
What "Assessment" Means for ICBC
Your initial appointment with a patient for an ICBC injury is billed as an assessment. That's your one opportunity to do thorough intake, baseline testing, and build your treatment plan.
If another practitioner of the same discipline has already assessed that patient for the same injury, you don't bill another assessment. You bill the standard session rate. One assessment per injury, period. You don't get a do-over if you (or your colleague) didn't catch everything the first time.
You'll be reassessing and reassessing throughout treatment—that's just good practice and part of your standard of care anyway. ICBC doesn't pay you more to do that. The only time you bill a separate assessment charge is if something has significantly changed or there's been a long gap requiring a formal re-evaluation. If you need to bill re-assessment sessions, you can request 1-3 from ICBC, but you'll need to defend your rationale for the request.
Session Minimums (The Part That Actually Matters)
ICBC specifies minimum treatment times for each discipline. Getting this right matters (for fraud reasons)
Physiotherapy: 20 minutes of direct treatment time
RMT: 45 minutes of direct treatment time
Kinesiology: 45 minutes of direct treatment time
Chiropractic: 15 minutes of direct treatment time
Acupuncture: 20 minutes of direct treatment time
"Direct treatment time" means one-on-one with the patient. It doesn't include intake paperwork, phone calls with ICBC, treatment plan development, or the patient sitting in your waiting room.
This is an important distinction, because treating for less than the minimum treatment time, while still billing for a “standard session” is insurance fraud. You don’t want to be accused of that. You certainly don’t want to do it accidentally.
If ICBC audits your clinic, they go through all your bookings, billings, and clinical notes to verify you met those minimums. Your documentation needs to clearly show that you provided the required direct treatment time—whether that was intake, hands-on work, or movement assessment. If ICBC finds that it's not clear that you met the minimum, that's not going to be great for your clinic, your practice, and your business.
Many practitioners choose to treat longer than the minimum and bill a user-fee. This is legitimate and smart. It gives you the time you need to do thorough work—not just treating the site of pain, but addressing compensatory patterns and other structures affected by the injury. When you bill a user fee, you're not limited to just the ICBC minimum, and the patient understands there's an out-of-pocket cost for extended care.
If you're billing ICBC directly at their rate, you need to hit the minimum. Period. Your scheduling and documentation need to reflect that reality. Don't bill an ICBC session if you can't deliver the minimum treatment time that day.
The Pre-Approved Session Counts
This is what ICBC covers in the first 12 weeks without requiring a treatment plan submission:
Physiotherapy: 25 sessions
Chiropractic: 25 sessions
RMT: 12 sessions
Kinesiology: 12 sessions
Acupuncture: 12 sessions
Counselling: 12 sessions
The big benefit of pre-approval is that patients can start immediately without waiting for authorization. They can also move between practitioners and clinics without anyone questioning it. That flexibility is useful for patients who want to actively seek out the right practitioner for them. That’s actually really cool.
After the initial 12 weeks (or when sessions run out, whichever comes first), you submit a treatment extension plan to ICBC. You provide documentation of progress, functional improvements, and clinical need. ICBC reviews it and usually approves additional sessions. There's no impending doom. There’s no treatment-end deadline. It's just a checkpoint where you submit updated documentation and keep going if the patient needs it.
If you see a need to ramp up treatment frequency during the initial window, you should. If it's clinically indicated. A patient making slow progress at 1x per week who could accelerate with 2x weekly sessions? That might be worth it. But not because the clock is ticking—because more intensive treatment serves the patient better.
Direct Billing vs. Patient Reimbursement (And Why Direct Billing Wins)
Direct billing: You submit to ICBC, they pay you, patient pays nothing out of pocket (unless they have a copay).
Patient reimbursement: Patient pays you, keeps the receipt, submits to ICBC themselves within 180 days, waits for reimbursement.
The issue is that it puts the administrative burden on the patient. They have to manage the submission timeline and wait for ICBC to process it. For your practice, you're waiting on patients to complete ICBC's paperwork instead of handling it directly.
Direct billing cuts out that extra step. You bill ICBC, they pay you, patient pays nothing upfront. It's better for your cash flow and it eliminates barriers to patients starting treatment.
What Sinks Billing Claims (And How to Avoid It)
Billing without having a valid claim number. Always verify the patient has an active ICBC claim. No claim number = you have to bill the patient and hope they get reimbursed. Bad situation.
Billing for sessions after the 12-week window closes. Week 13 sessions need extension approval or they won't be covered. If the patient didn't request an extension and you bill for week 13-15, ICBC declines the claim and the patient gets angry at you.
Not documenting the minimum treatment time. Your notes should reflect actual treatment time, not just "session." ICBC reviews this if there's a question.
Billing multiple patients on the same ICBC claim (accident with multiple passengers in one car). Each person gets their own separate claim. Different claim numbers. Don't mix them. We've seen this mistake cost clinics thousands in denied claims.
Session minimums not met. If you're billing a session and you didn't hit the minimum treatment time, don't bill it. Reschedule or bill a reduced amount (but this gets complicated—better to just not bill incomplete sessions).
Treatment Extension Approval
Sessions after the 12-week pre-approved window need explicit ICBC approval, but it’s not hard to get and it certainly is not the end of your patient’s care.
Here's the strategic part: submit your treatment extension plan two weeks before your pre-approved sessions expire. This gives ICBC time to review your documentation—progress, functional improvements, clinical need—and approve additional sessions before you actually need them.
When you time it right, there's no gap in care. Approval comes through, you keep treating, and you bill continuously. It's clean, it's paid, and your patient gets uninterrupted care. It requires a little bit of organization, but it’s worth it to see your patient recover well.
One More Thing: Rates Change Annually
ICBC adjusts these rates on April 1st every year. They’ll often send an email letting you know, but if you’ve unsubscribed from their messages, you’ll wan to set a calendar reminder. When they change, it’s worth it to update your billing system and your website right away, and you definitely need to tell your team they got a raise 🎉or maybe your patients now get to pay a smaller user fee.
(Pro tip: check in late March every year. ICBC publishes the new rates ahead of time, so you can plan for the change.)
Are you billing ICBC efficiently? If you're unsure about your current setup or want to optimize direct billing, we can talk through it. The difference between good billing practices and sloppy ones is thousands of dollars over a year.
Capria Care Collective | Coquitlam, BC | Training practitioners across Greater Vancouver on ICBC mastery.