Bulletin

    
Bulletin Number
        4355		 Date
        July 1, 2000		 Direct inquiries to

         Ministry of Health
         Processing Office

(address below)
Distribution
       Physicians, Hospitals, Clinics, Laboratories
Subject      Changes to the Physician Schedule of Benefits and Related Changes

1. Increase to Schedule of Benefits of 1.95% effective April 1, 2000
2. New or Amended Fees effective July 1, 2000
3. Discounted Fees Eliminated effective January 1, 2000
4. Threshold Levels Increased effective April 1, 2000

The Ministry of Health and Long-Term Care (MOHLTC) and the Ontario Medical Association (OMA) have reached a 4-year agreement. The agreement is effective from April 1, 2000 to March 31, 2004 inclusive. The following revisions to the Physicians Schedule of Benefits and physician payments implement the fee-for-service component of the Physician Services Agreement for 2000/2001. Other provisions of the agreement will be provided in a subsequent communication including the Maternity Leave Benefits Program.

These changes are being implemented July 1, 2000. The effective dates of the changes are indicated with each of the four items.

Please note that amended pages of the Schedule of Benefits have not been distributed with this Bulletin. Please use the information provided with this Bulletin to bill the new fee codes or you can access an updated version of the Schedule on the Ministry’s web site www.health.gov.on.ca. The across-the-board fee increase of 1.95% will be applied automatically to all claim submissions for services provided after April 1, 2000 and processed after July 1, 2000 with the exception of claims for the technical components of diagnostic services.

The Ministry of Health and Long-Term Care will publish a complete new edition of the Schedule that will incorporate all changes from February 1, 1998 to July 1, 2000. The new edition will be published in a smaller binder for distribution in July 2000.

1. Increase to the Schedule of Benefits

The Schedule of Benefits has been revised to provide a 1.95% increase to all fees, except technical fees for diagnostic services, effective April 1, 2000. As per the agreement, the Committee on Technical Fees will make recommendations regarding technical fees. The current 7% reduction to technical fees for services rendered in hospitals and independent health facilities is maintained. Technical fees for services rendered in other locations will continue to be subject to the first level of threshold reduction.

The amounts payable for insured services that are rendered on or after July 1, 2000 will be set out in the new edition of the Schedule of Benefits. Retroactive payments for services that are provided on or after

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