for each repeat therapy, recurrent or persistent CNV leakage is
detected by fluorescein angiography and documented by retinal photographs
retained on the patient's permanent medical record.
the patient's clinical condition meets all the above criteria but retinal
photographs are not made prior to the procedure and retained on the
patient's permanent medical record or the procedure is not performed by an
ophthalmologist, then PDT is an insured service payable at nil.
Maximum one PDT (unilateral or bilateral) per patient per day.
G460 - unilateral PDT per patient per day ........................$300.00
G461 - bilateral PDT per patient per day ...........................$375.00
G379 rendered to same patient in conjunction with G460 or G461 is
an insured service payable at nil.
G460 rendered to same patient same day as G461 is an insured
service payable at nil.
Assessments and angiography are payable in addition to PDT. Retinal
photography is insured as a specific
The above fees for PDT have been introduced on an interim basis and
will be subject to a joint review by the
PDT will normally not be administered to each affected eye more
frequently than once every 3 months.
PDT performed for treatment of clinical conditions other than
described above is uninsured.
heading of Consultations and Visits listings for Ophthalmology (23) will
be amended on June 15, 2002 to include a note on page A32 to the effect:
Ophthalmology consultations and visits may include retinal photography as
a specific element of the insured service, where medically
Ministry of Health and Long-Term Care will fully cover the verteporfin
drug used in performing PDT on eligible patients.
The Priority Programs Unit, Hospitals Branch, Health Care Programs
Division will manage the funding of the drug.
2002/03, the Ministry of Health and Long-Term Care will designate up to
eight public hospitals across Ontario to monitor verteporfin usage by
designated ophthalmologists. The
designated hospitals are: London Health Sciences Centre - Ivey Eye Clinic,
Hamilton Health Sciences Corporation, William Osler - Peel Memorial,
University Health Network - Western Division, Sunnybrook and Women's College HSC,
The Ottawa Hospital, Kingston
Hotel Dieu and Sudbury Regional Hospital. These hospitals will also
receive, gather and submit relevant supporting information to the ministry
on a monthly basis for funding reconciliation.
drug and kit will be distributed by the Ontario Government Pharmacy based
on orders backed up by a Patient Registration Form received from the
aforementioned hospitals as directed by ophthalmologists who have
registered as authorized providers with the Priority Programs Unit.
|Ontario Ministry of Health and Long-Term Care
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