PAGE 2 of 4  

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

Effective August 1, 2003 2 new fee codes will be introduced into the Schedule and 89 existing codes will be increased to rebalance sectional inequities.

  1. What services have received fee increases in the Schedule?

    Fee increases to 172 existing codes are retroactive to April 1, 2003 and include Pap smear tests, ear syringing, post natal care in office, subsequent visits to nursing homes and chronic care to promote improved access to primary care and long-term care. These increases will support physicians in their delivery of primary care services and ensure that hospitals can attract sufficient human resources to provide necessary services.

    Effective August 1, 2003, fee increases will be implemented to rebalance specialty inequities in psychiatry, geriatrics, obstetrics and gynaecology, general surgery, family medicine, and internal medicine including rheumatology to ensure that all physicians are remunerated in a fair and equitable manner.
     
  2. Have any decreases to fees been made?

    Only 6 codes (in the areas of sleep studies and loop recorder monitoring) will receive fee decreases and tightening of service descriptions in the Schedule. These are services that are now considered to be overvalued as a result of improvements in medical technology and changes in current standards of practice. These changes are effective July 1, 2003. Specific codes are:

    G653, G654, G655: Continuous ECG monitoring – Loop recorder
    J890: Overnight Sleep Studies (Level 1)
    J889: Overnight Sleep Studies – therapeutic study for CPAP Titration (Level 1)
    J891: Overnight Sleep Studies (Level 2)

    A total of 5 services will be deleted from the Schedule:

    Z559: Endoscopy – repeat within 90 days of previous Z558
    This service will now be billed using the existing higher fee Z558, which is used for the first procedure, since it is recognized that the service is no less complicated when repeated than when it was first performed.

    Z579: Endoscopy – repeat within 90 days of previous Z561
    This service will now be billed using the existing higher fee Z561, which is used for the first procedure, since it is recognized that the service is no less complicated when repeated than when it was first performed.
     

Ontario Ministry of Health and Long-Term Care
© 2002 Queen's Printer for Ontario  |  Last Modified:  06/15/2009 09:52:54