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In the News

Bulletin 240301 

  • New payment rules are being applied to fee codes:
    • N291A, N293A – Nerve Transfer Procedures
      • Eligible for payment to the same physician as well as different physicians for the same patient on the same day
      • When both are claimed by the same physician within a 14-day period, the first submitted will pay 100% and the second reduced to 85%
      • E906A will pay 40% of N291A and N293A
      • E925A will pay 30% of N291A and N293A
      • Effective April 1, 2023
    • K711A – Nuclear medicine participant for case conference
      • K711A can only be billed up to 5 services per day by any physician
      • K711A is not eligible for payment on the same day as K708A, K709A or K710A
      • Effective April 1, 2023
    • A772A, C772A – Medical certificate of stillbirth
      • Only one A772A or C772A is eligible for payment on the same day by the same or different physicians
      • A772 and C772 are not eligible for payment as a virtual service
      • Effective July 1, 2023

Bulletin 240302

  • Update: Information for the Northern Physician Retention initiative for 2023-24 is now available on Ontario.ca

Bulletin 240304

  • Update: Adjustments described in Bulletin 230310 and 230604 have been completed
  • Medical Claims Adjusting Processing has been performed on the following fee schedule codes:
    • E117A
    • E124A
    • E186A/C
    • E202A
    • Z844A
    • E175A
    • E147A
    • E149A
    • Z581A
  • If claims have been reprocessed at a lesser value your SBS clerk will be in touch with more information

Bulletin 240306

  • The Ministry will temporarily increase physician payments by 2.8% for the period April 1, 2023 to March 31, 2024
  • Funding for Specialist Physician Alternative Payment Plans (APPs) “will flow as soon as practicable”
  • Payment for April 1, 2023 to March 31, 2024 will flow in the Fall of 2024

Bulletin 240307

  • The Ministry will temporarily increase physician payments by 2.8% for the period of April 1, 2024 to March 31, 2025
  • Physician contract payments tied to shadow billing will receive the temporary 2.8% increase

Bulletin 240310

  • E409 and E410 – After hour premiums
    • As of March 31, 2024 these premiums will no longer be eligible for payment for elective procedures
  • G593 – COVID-19 vaccine will continue

Bulletin 240401

  • New payment rules are being applied to E098A – Gastroenterology Chronic Disease Assessment Premium
    • E098A will only be eligible for payment to physicians with an OHIP specialty of 41 – Gastroenterology
    • E098A will pay a 28% premium on A411A, A413A, A414A, A418A when claimed with diagnosis codes:
      • 555 – Other diseases of intestines and peritoneum: Regional enteritis, Crohn’s disease
      • 556 – Other diseases of Intestine and Peritoneum: Ulcerative colitis
      • 571 – Other diseases of Digestive System: Cirrhosis of the liver (alcoholic cirrhosis, biliary cirrhosis)
    • E098A provided in-person or virtually will not by itself establish the patient/physician relationship
    • E098A is not eligible for after hour premiums E409A, E410A, E412A and E413A
  • These changes were implemented April 1, 2024 with an effective date of April 1, 2023

Bulletin 240403

  • Go Secure is being replaced by OPS BPS Secure in 2024
  • The Go Secure login screen, landing page and account maintenance will have a new look and feel
  • Estimated completion and migration is summer 2024