Ohip Bulletin and Govenment logo
Bulletin Number

4395

Date

December 30, 2002

Direct inquiries to

Ministry of Health and Long-Term Care Processing Office

(See Address Below)
Distribution

Physicians, Hospitals, Clinics, Laboratories


Subject

Physician Supervision of Simple Office Procedures

Further to OHIP Bulletin #4140 titled "Direct Physician Supervision of Venipuncture", the Ministry of Health and Long-Term Care in consultation with the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO) has reviewed the above payment policy and has agreed to expand the list of simple office procedures that may be billed to OHIP when provided by a non-physician without requiring the physical presence of the physician in the private office at the time the service is rendered. For the purpose of payment by OHIP, the insured procedures provided by the non-physician are subject to the following :

  1. Only simple office procedures listed in the following table may be performed by the non-physician without the physical presence of a physician in the physician's office;
  2. The procedure rendered must be in "accordance with accepted professional standards and practice" [Sec 18 (2) of the Health Insurance Act]. The non-physician performing the procedure must have been properly trained and reports to the physician (Section B.10 of the General Preamble of the Schedule of Benefits);
  3. The physician orders the procedures on his or her patient only, as evidenced by either an ongoing physician/patient relationship or a consultation/assessment by the physician the same day;
  4. Either a locum tenens replacing an absent physician in the absent physician's office or the physician may claim payment for procedures performed by the non-physician; and
  5. The same record-keeping requirement must be met as if the physician personally had rendered the service. The record must be dated, identify the non-physician performing the service, and contain a brief note on the procedure performed by the non-physician.

These policy changes will be effective for service dates on or after January 1, 2003.