Bulletin

   
Bulletin Number
        4375
Date
        October 29, 2001
Direct inquiries to

         Ministry of Health
         Processing Office


(address below)
Distribution

           Physicians, Hospitals, Clinics, Laboratories

Subject     

Influenza Vaccination - Insured Physician Services

Influenza vaccination is an insured service under the Schedule of Benefits for physician services.

 Fee-for-Service Claims

On April 1, 2001, the requirement that influenza immunization was insured only for people who were eligible to receive publicly funded influenza vaccine was removed. See Bulletin 4367. The fee codes for the administration of influenza vaccine are

                              G590            Influenza immunization- with visit                     $3.70

                              G591            Influenza immunization – sole reason                $8.40

When influenza immunization is the sole service provided during the patient encounter, G591 is payable. The fee for G591 includes any evaluation of the patient with regard to the patient receiving the vaccine. G590 is payable with a visit when the reason for the visit is not related to the flu vaccine. It is inappropriate to claim Active Immunization codes (G538 and G539) for administration of influenza immunization. 

Requirements for Delegation

For payment purposes, the physician must personally administer the vaccine or delegate the procedure in accordance with the rules for delegated procedures i.e.

  • the vaccine is administered by a person who is an employee of the physician; and

  • the person is under the direct supervision of the physician; and

  • the physician is physically present in the office or clinic at which the delegate is administering the vaccine to ensure that the procedure is being performed competently; and

  • the physician is immediately available at all times to approve, modify or otherwise intervene in the procedure as required in the best interest of the patient.

For complete information about physician payment for delegated procedures, see the Schedule of Benefits, General Preamble, B.10, Delegated Procedure, page xxv.

In addition, the College of Physicians and Surgeons of Ontario standards for delegating a controlled act apply when administration of the vaccine is delegated to a person who is not authorized to do so by the Regulated Health Professions Act. For further information about delegating a controlled act, refer to the College of Physicians and Surgeons of Ontario policy statement The Delegation of Controlled Acts dated November 1999.

../2

Office locations
Barrie
30 Poyntz St.
L4M 3P2
Hamilton
119 King St. W
P.O. Box 2280, Stn. A
L8N 4C8
Kenora
220-808 Robertson St.
P9N 1X9
Kingston
1055 Princess St.
P.O. Box 9000
K7L 5A9
Kitchener
1400 Weber St. E. Unit B2
N2A 3Z8
London
217 York St., 5th FloorP.O. Box 5700 Terminal A
N6A 1B7
Mississauga
201 City Centre Dr.
P.O. Box 7020, Stn. A
L5A 3M1
North Bay
101-447 McKeown St.
P1B 9S9
Oshawa
Exec. Tower, Oshawa Centre. 419 King St. W.
P.O. Box 635 L1H 8L4
Ottawa
Fuller Building
75 Albert Street
K1P 5Y9
Owen Sound
981 2nd Avenue E.
N4K 2H5
Peterborough
550 Lansdowne St. W.
K9J 8J8
St. Catharines
59 Church St 3rd Floor
L2R 3C3
Sarnia
452 Christina St. N.
N7T 5W4
Sault Ste. Marie
Roberta Bondar Place
70 Foster Dr., Ste. 100
P6A 6V4
Sudbury
199 Larch St.,
Suite 801
P3E 5R1
Thunder Bay
435 James St. S. ,
Suite 113
P7E 6T1
Timmins
38 Pine St. N., Ste. 110
P4N 6K6
Toronto
2195 Yonge St.
P.O Box 1700 Stn. A
M5W 1G9
Windsor
1427 Ouellette Ave.
N8X 1K1
Head Office
P.O. Box 48
Kingston, ON
K7L 5J3