-3-

Fee Code

Descriptor

Newly added test that modifies conditions of payment is underlined.

Deleted text is crossed out.

New (N)
Revised (R)

Deleted (D)

+G470

Ultraviolet light therapy (general or local application) and/or Psoralen plus Ultraviolet A (PUVA), is an insured service only for treatment of dermatological conditions (maximum 1 per patient per day). G470 is an insured service payable at nil if rendered in a hospital in-patient or out-patient department or physiotherapy facility listed in Schedule 5 under Regulation 552 of the Health Insurance Act.

[Commentary - See General Preamble for conditions and limitations regarding delegation and supervision of G470.]

$7.60

N

G467

Miscellaneous therapeutic procedures

 

D

G264

Occipital nerve - first block per day (maximum 1 per day regardless of number of occipital nerve blocks rendered to a maximum of 16 first blocks per calendar year)

 

R

G265

Occipital nerve - each additional unilateral block following G264, per spinal level per day (maximum 3 per day following G264 to a maximum of 48 additional unilateral blocks per calendar year)

 

R

G291

Occipital nerve- first block per day in excess of 16 per calendar year may be payable on an independent consideration (IC) basis upon submission to the ministry of a written recommendation of an 'independent expert' as described below (maximum 1 per day to a maximum of 16 blocks for a single IC request). A new written recommendation is required on an IC basis each time the number of first blocks exceeds 16.

$19.25

N

G292

Occipital nerve - each additional unilateral block following G291, per spinal level per day when G291 is payable in full (maximum 3 per day)

$9.70

N

 

Note:

1.      G265 and G292, are insured services payable at nil unless an amount is payable for G264 or G291 rendered to the same patient the same day.

2.      When an amount is payable for G264, the amount payable for G291 rendered to the same patient on the same day is nil.

3.      When an amount is payable for G265, the amount payable for G292 rendered to the same patient on the same day is nil.

4.      For the purpose of G291, 'independent expert' in respect of a patient is a physician who:

i.       has special knowledge and expertise in multidisciplinary management of chronic non-malignant pain;

ii.      did not refer the patient for treatment;

iii.     is not actively involved in management of the patient; and

iv.     receives no direct or indirect financial benefit form nerve block services being rendered to the patient.

[Commentary - See Appendix B regarding conflict of interest.]

 

 

G442, +G529

Automatic impedance audiometry - by manual or automated methods, and may include stapedial reflex and/or compliance testing:

 

R

G450

Sound field audiometry

$5.55

R

G443, G530

Miscellaneous advanced testing… Central auditory at the request of third parties eg. school boards is not a benefit. See Appendix F regarding third party services. (Deleted text is relocated to DHT preamble.)

 

R

G434, G527

Manual impedance testing

 

D

G447, +G531, G445, +G446

Hearing aid evaluation and/or fitting of a tinnitus masker and re-evaluation or re-fitting

 

D

Communications

Bulletins, Fact Sheets and the updated version of the Schedule are available July 1, 2001 on the Ministry of Health and Long-Term Care website at www.health.gov.on.ca.


Ontario Ministry of Health and Long-Term Care
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