The following are deemed not to be insured services: A service provided by a laboratory, physician or hospital that supports a service that is deemed not to be an insured service.

G. Follow-up Diagnostic Professional Fees
In specified circumstances, a repeat diagnostic service by the same physician previously rendering a consultation is payable at the same rate as Professional Component P2. The following is added to the "Specific Elements" section of the Nuclear Medicine preamble page B1 and Diagnostic Ultrasound preamble page G1:

The amount payable for the Professional Component P1 for a service rendered to a patient shall be reduced to the amount payable for the same service at the Professional Component P2 rate where the physician who renders the P1 service has:

  1. Rendered an assessment of the same patient within 30 days immediately preceding the day upon which the P1 service is rendered to that patient; AND
  2. Rendered any consultation( full, limited or repeat) in respect of the same patient within the 365 days immediately preceding the day upon which the P1 service is rendered to that patient.

The preamble to Diagnostic and Therapeutic Procedures page J1 is changed so the first paragraph below Non-Invasive Diagnostic Procedures reads:

Some non-invasive diagnostic procedures are divided into a technical component and a professional component which, for some services, may have two levels identified as P1 and P2. The amount payable for the Professional Component P1 for a service rendered to a patient shall be reduced to the amount payable for the same service at the Professional Component P2 rate where the physician who renders the P1 service has:

  1. Rendered an assessment of the same patient within 30 days immediately preceding the day upon which the P1 service is rendered to that patient; AND
  2. Rendered any consultation ( full, limited or repeat) in respect of the same patient within the 365 days immediately preceding the day upon which the P1 service is rendered to that patient.

H. Chronic Dialysis Team Fee
Amend page J11 to delete entries for G326, G332 and G333, including description for home/self -care dialysis and note below G333. Insert new subheading and fee description as follows below entry for R854:

Chronic Dialysis Team Fee - is the all-inclusive benefit per patient per week for professional aspects of managing chronic dialysis and end-stage renal failure in dialysis patients. It is a modality independent fee and is equal in monetary value whether the dialysis is delivered in hospital, community or home and whether it is hemodialysis or peritoneal dialysis. The team fee includes the services of all physicians routinely or periodically participating in the patient’s dialysis treatment at:

  1. the patient’s principal treatment centre;
    or
  2. at a place other than the patient’s principal treatment centre ("auxiliary treatment centre") where 3 or more dialysis treatments are rendered to the patient during the 7-day period referred to below.

The amount payable is in respect of a 7-day period of care, commencing at midnight Sunday and is payable to the most responsible physician. Except as set out below, the amount payable to another physician in respect of these services rendered to a patient in respect of whom a claim is submitted and paid for this code, is nil.

When a full 7-day period of team care is not rendered at the patient’s principal treatment centre due to absence of the patient with treatment at an auxiliary treatment centre, the amount claimed for treatment at the principal treatment centre is reduced on a pro rata basis to equal 1/7 of the weekly fee for each day that the patient is the responsibility of the principal treatment centre.

In addition to the common elements of insured services and the specific elements of Diagnostic and Therapeutic Procedures, the team fee includes the following elements:

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Ontario Ministry of Health and Long-Term Care
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