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