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Ontario Health Insurance Plan

OHIP Bulletins


INFOBulletin

Keeping Health Care Providers informed of payment, policy or program changes

Interprovincial Health Care InfoBulletins

To: All Health Care Providers

Published by: Claims Services Branch

Date Issued: May 17, 2017

Bulletin Number: NA80

Re: 2017/18 Interprovincial Hospital Billing Rates Effective April 1, 2017

Posted Electronically Only

PDF Version Portable Document Format | 179kb 


This INFOBulletin replaces INFOBulletin 3114 - Physiotherapy Stale Date Submission issued June 5, 2015.

The Interprovincial Health Insurance Agreements Coordinating Committee has introduced updated interprovincial hospital rates for inpatient services, well newborn services, out-patient services, high cost transplants and high cost implants/devices provided on and after April 1, 2017. These rates are attachments to this bulletin.

Please note a change in the Out-Patient Rates to service code 13 and a new corresponding rule of application (#10).

Additionally, please note that hospitals may claim invoice costs for a number of new special implants/devices as listed on the Special Implant/Device Rates sheet.

In order to efficiently process your hospital's reciprocal billing claims, the Ministry requires that all invoices contain your hospital corporation's 3-digit facility number and the correct rate.

The Ministry is moving towards discontinuing the submission of reciprocal billing claims via paper. If your hospital has not migrated from paper to electronic submission, please have your IT department follow the technical specifications located at the link below in order to complete that migration: http://www.health.gov.on.ca/en/pro/publications/ohip/docs/techspec_icd.pdf.

In addition, please register your hospital for Medical Claims Electronic Data Transfer (MCEDT) internet based claims submission. This website contains information about MCEDT in general: http://www.health.gov.on.ca/en/pro/publications/ohip/mcedt_mn.aspx.

For inquires related to reciprocal hospital billing, please refer to the information below to determine the best area of contact:

Please share a copy of this INFOBulletin with the billing department at your hospital.

See attachmentments titled:


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