OHIP Bulletin 3068- Page 2

PAGE 2 of 4

CHANGES TO OHIP-INSURED PHYSIOTHERAPY SERVICES EFFECTIVE APRIL 1, 2005.

(3) Maximum number of services:

• A maximum of 100 insured services per person per year are insured for those younger than 20 and 65 years of age and over.
• A maximum of 50 insured services per person per year are insured for post acute hospitalization individuals between 20 and 64.

Note: Eligibility for all services continues to depend on medical need. Where services beyond the identified maximums may be required a process based on medical need is being developed. Information on this will be communicated separately

(4) Coverage for Ontario Disability Support Program (ODSP) Family Benefits Program and Ontario Works: :

MOHLTC in conjunction with the Ministry of Community and Social Services (MCSS) has developed a payment mechanism to ensure recipients of Ontario Disability Support program (ODSP), Family Benefits Program and Ontario Works (OW) are able to receive funded physiotherapy services.

(5) Fee code changes:

Changes to fee codes are summarized below. The six-month limitation period for the submission of billings still applies for insured services rendered to insured persons by approved facilities on or before March 31, 2005.

Fee Codes to be Delisted effective April 1 2005:

Fee Code	Description	Fee
V821	Initial visit – office	$12.20
V823	Final service – office	$12.20
V824	Final Service - home	$24.40
V825	Home service - additional patient same site	$12.20

Insured Fee Codes effective April 1, 2005:

Fee Code	Description	Current Fee
V822	Initial visit - home	$24.40
V826	Initial visit – Long-Term Care Facility	$24.40
V827	Subsequent visit– Home/Long-Term Care Facility	$12.20
V829	Clinic visit – ambulatory service 65+	$12.20
V830	Clinic visit – ambulatory service 19 and under	$12.20
V831	Clinic visit - post acute hospitalization	$12.20
V840	Clinic visit – ODSP recipient, Family Benefits Program recipient and OW recipient	$12.20

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