Ohip Bulletin and Govenment logo
Bulletin Number

9073

Date

March 29, 2004

Direct inquiries to

Ministry of Health and Long-Term Care Processing Office

(See Address Below)
Distribution

Dental Surgeons

Subject

CHANGES TO DENTAL SCHEDULE OF BENEFITS EFFECTIVE APRIL 1, 2004

Fee Increase for Dental Services
The 5 year funding agreement between the Ministry of Health and Long-Term Care and the Ontario Dental Association (ODA) provides for an annual incremental fee increase of 2% plus an annual incremental repair to base amount of 1% which can also be applied to fees. This fee increase will be applied to 83 designated fee codes for year 3 of the agreement (commencing April 1, 2004).

New Fee Codes for Dental Services
The agreement provides for annual targeted funding of $300,000 for each year of the agreement to introduce new fee codes which represent technological advances in dentistry. Year 3 introduces 21 new fee codes for surgical exploration, incision and drainage, biopsy and cytology and other dental procedures and services. These new codes come into effect for services rendered on and after April 1, 2004.

Removed Fee Codes for Dental Services
No fee codes have been removed for year 3 of the agreement.

Clarification of billing for codes T901 – T912
Claims for the above codes are per quadrant.

T901 is payable at 100% once for each quadrant of the mouth. Removal of additional erupted teeth in the same quadrant is described as fee code T902.

T903 – T912 is payable at 100% for the first tooth in each quadrant. Additional teeth in the same quadrant that qualify are payable at 85% of the listed benefit.