Learn More >

Ministry Status: Activation Status

Ontario Health Insurance Plan

OHIP Bulletins


Keeping Health Care Providers informed of payment, policy or program changes

To: Independent Health Facilities Licences with Limiting Conditions on Licence Pertaining to Ultrasound Services in Support of Infertility

Published by: Health Services Branch, Ministry of Health and Long-Term Care

Date Issued: April 26, 2018

Bulletin Number: 2135

Re: Requirements for Independent Health Facilities (IHFs) with Limiting Conditions of their Licence Pertaining to Infertility and Amendments to the Limiting Conditions of the Licence

Posted Electronically Only

PDF Version Portable Document Format | 1 Mb | 

This bulletin provides further information regarding ultrasound services for Independent Health Facilities (IHFs) licensed under the Independent Health Facilities Act (IHFA) to provide general ultrasound or obs/gyn ultrasound services, where the licence specifies that such services are limited to specialty ultrasound for the associated investigation of infertility/IVF and cycle monitoring.

Prior to September 1, 2017, IHFs providing ultrasound services in support of patients of a specific fertility clinic were limited to “the associated investigation of infertility/IVF and cycle monitoring”. These limitations were not intended to include ultrasounds to patients once they became pregnant. Upon pregnancy, the limiting conditions of the licence did not allow the IHF to bill the technical fee for obstetrical ultrasounds in support of pregnancy.

Effective September 1, 2017, obstetrical ultrasounds, following the investigation of infertility and cycle monitoring/natural conception, can be provided once a patient becomes pregnant, up to and including the patient’s 10th week of pregnancy. This is further expanded to include patients who underwent fertility investigation, monitoring or treatment, up to and including the patient’s 10th week of pregnancy. The patients must be patients of the physician’s practice or facility as noted on the limited licence.

Once a patient reaches the 11th week of pregnancy, ultrasounds performed, such as nuchal translucency, are considered to be obstetrical ultrasounds and therefore do not fall under the investigation of infertility/cycle monitoring/natural conception or for the investigation of infertility/treatment.

Amended licences and conditions and limitations of the licence have been sent to all IHFs who had licencing conditions limited to “the associated investigation of infertility/IVF and cycle monitoring”. The limitations have now been updated to read as follows:

the patients of a [specified clinic/physician] in the:

    1. associated investigation of infertility and cycle monitoring to support natural conception; and
    2. Early pregnancy monitoring up to and including the patient’s 10th week of pregnancy only for patients who underwent fertility investigation, monitoring, or treatment at [specified clinic].

The IHF Program reminds licensees to visit the IHF ministry webpage regularly for updates specifically related to IHFs. It is your responsibility to review the Schedule of Facility Fees for Independent Health Facilities (the Schedule) to ensure that you are submitting claims using the correct fee schedule codes and following the applicable Preambles at the beginning of each section.

The Schedule may be found on the IHF Program webpage.

If you require further information please contact the IHF Program by telephone at 613-548-6637

To view Portable Document Format PDF files, you will need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe website.

For More Information

Call ServiceOntario, Infoline at:
1-866-532-3161 (Toll-free)
In Toronto, (416) 314-5518
TTY 1-800-387-5559.
In Toronto, TTY (416)327-4282
Hours of operation: Monday to Friday, 8:30am - 5:00pm

  • Connect With Us
Facebook Twitter YouTube RSS