Bulletin

   
Bulletin Number
        4369
Date
        June 22, 2001
Direct inquiries to

         Ministry of Health
         Processing Office


(address below)
Distribution
  1.  Physicians, Hospitals, Clinics, Laboratories

  2. Independent Health Facilities
Subject     

Changes to the Ministry of Health and Long-Term Care Schedule of Benefits for Physician Services Effective July 1, 2001

The following changes are being implemented July 1, 2001 as part of the Ministry's agreement with the Ontario Medical Association to achieve a $50 million annual savings through modernization and tightening changes to the Schedule of Benefits.  Transitional payment provisions will be in place while physicians incorporate changes into their office practices.  Physicians can call their local district office for details.

 1. Diagnostic and Therapeutic Procedures:  Physical Medicine

With the exception of ultraviolet light therapy (see paragraph “2” below), the therapeutic modalities listed under G467 -- Miscellaneous therapeutic procedures are not insured.  Uninsured miscellaneous therapeutic procedures are defined as physical therapy, therapeutic exercise and may include thermal therapy, ultrasound therapy, hydrotherapy, massage therapy, electrotherapy, magnetotherapy, transcutaneous nerve stimulation and biofeedback. 

 2. Diagnostic and Therapeutic Procedures:  Dermatology

 "Dermatology" is a new sub-section under Diagnostic and Therapeutic Procedures.

Ultraviolet light therapy and/or Psoralen plus Ultraviolet A (PUVA), only for treatment of dermatologic conditions is added in a new Dermatology sub-section under Diagnostic and Therapeutic Procedures to replace services that would otherwise be delisted with G467. Conditions regarding delegation and supervision, as per General Preamble B.10, Delegated Procedure, apply to this service. The supervising physician must be present in the office or clinic. If the supervising physician is not present, the service remains insured but the amount payable is nil.

 3.      Diagnostic and Therapeutic Procedures:  Nerve Blocks

A maximum of 8 per patient per day for any combination of nerve blocks. The ninth and subsequent nerve blocks per patient per day are insured services payable at nil. Nerve blocks, which are defined as a bilateral procedure, are counted as two services for the purpose of the overall daily maximum.

G243, G244, G241, G242, G231 and/or G223 claimed in addition to or in lieu of G260 and rendered to the same anatomical site during the same visit are insured services payable at nil.

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