Changes to the Schedule of Benefits for Physician Services
Questions and Answers

  1. What are the changes to the Schedule of Benefits for Physician Services?

    Changes to the Schedule of Benefits include the introduction of 21 new fee codes including the introduction of 2 new services -scintimammography and endoscopic ultrasound. Other changes provide fee increases and revisions to existing codes, deletion of obsolete codes and decreases to some fee code values in order to maintain relativity. The changes will be introduced in three phases on April 1, July 1, and August 1, 2003.
     
  2. Why are changes being made to the Schedule of Benefits?

    These changes are required as part of the 4th year re-opener activities of the Physician Services Agreement between the ministry and the OMA that is in effect until March 31, 2004. Many changes are required to recognize changes in medical standards of practice and technology.
     
  3. How does the ministry decide what new services should be insured?

    The ministry recommends the addition of new services that are required to support ministry initiatives or in response to stakeholder advice. Many new services and other changes are based on the advice of medical experts within the OMA who can advise the ministry on changes in medical standards of practice and technology. The ministry and the OMA jointly approve all recommended changes arising from implementation of the Physician Services Agreement.
     
  4. How will these changes be funded?

    These changes will be covered by the existing 2% already committed under the 2000 Physician Services Agreement plus an investment of $90 million added to the Physician Services Budget as a result of the 4th year re-opener negotiations.
     
  5. What new services have been introduced into the Schedule?

    Effective July 1, 2003 a total of 21 new fee codes have been introduced into the Schedule and 124 existing codes are revised to reflect current standards of practice including scintimammography, endoscopic ultrasound, endoscopic placement of stent, pace maker lead extraction, implantation of coronary sinus pacing lead, and specific neurocognitive assessment.

Ontario Ministry of Health and Long-Term Care
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