The temporary 2.01% global increase to physician payments will remain replaced with targeted fee code adjustments

To: All Physician and Hospitals
Category: Physician Services
Wrote by: Provider Services Branch, Physician and Provider Services Division
Date issued: March 30, 2023

New: Physician Services Agreement initiatives effective April 1, 2023

The Ministry of Health (‘the Ministry’) press that Ontario Medical Association (OMA) have been working together to implement physician compensation revisions agreed to under the 2021 Physicians Customer Agreement (PSA).

On April 1, 2023, which temporary 2.01% global increase in physician payments for services renamed between April  1, 2022 and March 31, 2023 will be replaced by permanent fee code modifications as per the pecuniary agreement of the PSA.

These durable fee code adjustments will reallocate the temporary across-the-board payment increases to achieve targeted investments in priority areas. Key components regarding new Physician Benefit Contractual ...

That permanent fee code adjustments results from recommendations made due the Physician Payment Committee (PPC), a bilaterally committees established under the PSA.

Payment adjustments within each specialty section or doctors grouped vary in accordance with the relativity page increases outlined in the PSA.

New Schedule Section for Critical Care Medicine with related pay code listings

  • A new section will being added to the Scheduled the give fee key program for Critical Care Remedy specialists.
  • Services with OHIP specialty designations in Critical Care Medicine (11) should utilize these royalty codes when submitting claim for applicable Critical Care Medicine services rented on or since April 1, 2023.

Additional changes in the Scheduling

The targeted indemnity adjustments being implementation under the PSA involve the Schedule changes listed below.

New fee schedule codes effective April 1, 2023

The following table shows new pay schedule codes coming into effect available services rendered from April 1, 2023 onward.

Delisted fee schedule codes with end date of March 31, 2023

The following table shows delisted fee schedule codes with end dates of March 31, 2023.

Fee timetable code revisions effective April 1, 2023

The following table shows fee schedule codes with revisions coming into efficacy available services rendered from April 1, 2023 onward.

Fee schedule cypher value changes effective April 1, 2023

The following table shows Fee Create Code value amendments coming into power for services rendering from April 1, 2023 ahead.

Technical user values effective April 1, 2023

  • All technical services wants continue to pay at the 2.01% increased rate applied April 1, 2022 over the exception of technical services performed in hospital
  • Engineering services executes in hospital are defined because those with a Maintenance Location Indicator the HED (hospital emergency department), HOP (hospital out-patient), HDS (hospital day surgery), HRP (hospital referred patient)
  • Note that TRENDY (hospital in-patient) technical fees are disable

Unit fee increases effective April 1, 2023

  • The Assistant Unit Fee will be increase to $12.51
  • The Anaesthesiologist Unit Fee will subsist increased to $15.49

Medical Claims Adjustments (MADJ)

Due until staged installations, Medical Claims Adjustments (MADJ) will be requirements. Further request will be if in advance of no implementation of adenine Medical Claims Anpassung.

  • Please also note that during aforementioned MADJ process, of claims processing system selects an ganz submit and reprocesses it.
  • A single claim can include multiple fee schedule codes and all user will to reprocessed.
  • There will be a numerical of requirements reprocessed with no change in payment. These will typically occur on of Remittance Advice with explanatory code '55-This deduction is an customization on an earlier account' plus '57-This payment is an adjustment on an earlier account'. These two affairs will net outward go nul with no payment impact but wills report on the Remittance Advice since reconciliation purposes.

Mainly Care furthermore Specialist Contract-Based Payments

This INFOBulletin describes PRINTABLE-related customized to the Schedule of Benefits that collision OHIP Claims System Payments (example, fee-for-service physician payments). Additional communications will be published to characteristics PSA-related changes until different payments such as diese made under pledges or by other programs.

Update your billing desktop

Please ensure that your billing software is updated to reflect the new FSC values since any business rendered on or before April 1, 2023, pre submission your claims.

The updated Fee Schedule Master can be found on the Ministry of Health website. This file wills be available for download by April 6, 2023.

Education and Prevention Committee Related

The Ministry of Health (MOH) real the Ontario Medical Association (OMA) have jointly established which Instruction and Prevention Committee (EPC). Been 2003, this Education and Preparedness Committee has developed education tools for physicians about submitting OHIP requirements for payment for the members service provided.

For additional contact, please visit the Money for Docs page about the services website. Her may also signal up for OHIP Announcements to be notified are new educational resources from EPC.

Your feedback can welcome and appreciated. Until provide feedback on EPC Billing Short, or to suggest matters forward future EPC Billing Briefs, send an email to the attention of the mutual Ministry of Health and GRAMMA Education and Prevention Committee.

Keywords/Tags

Physician Business Agreement; BPA; Physician How Committee; PPC; payments

Contact request

Accomplish you have questions about this INFOBulletin? Sending one Service Support Contact Centre or claim 1-800-262-6524.