Ontario Health Insurance Plan

INFOBulletin

Physician Remuneration for COVID-19 Vaccination Services

This bulletin provides guidance on how physicians should submit claims to OHIP in order to be paid for COVID-19 vaccination services


To: Physicians
Category: Physician Services
Written by: Health Services Branch, Ontario Health Insurance Plan Division
Date issued: February 11, 2021
Bulletin Number: 210204


COVID-19 Vaccination Services Rendered at Vaccination Sites coordinated by Public Hospitals or Public Health Units

Physicians supporting vaccination services at hospital or public health unit (PHU) coordinated COVID-19 vaccination sites must claim the H409 and H410 sessional fee codes-as appropriate to the circumstance-for each hour of work (or major part thereof).

Fee Code

Fee Code Description

Fee Code Amount

H409

COVID-19 Sessional Unit-per one-hour period, or major part thereof

$170.00

H410

COVID-19 Sessional Unit-per one-hour period, or major part thereof on Saturdays, Sundays, holidays or Monday to Friday afterhours (5pm-7am)

$220.00

The H409 and H410 fee codes provide comprehensive remuneration for all insured services rendered during the applicable time period and for being present at the vaccination site to provide such services. No other fee codes are eligible for payment during the applicable time periods.

The H409 and H410 fee codes are also eligible for payment for COVID-19 vaccination planning, administrative, or leadership services when requested by a hospital or by a PHU.

The H409 and H410 fee codes must be submitted with the group number assigned to the hospital or PHU that coordinated the vaccine service delivery. This information should be obtained from the hospital or PHU vaccination lead or the COVID-19 Assessment Centre administrator of the coordinating entity.

All services rendered on or after December 14, 2020 at hospital or public health unit (PHU) coordinated COVID-19 vaccination sites are eligible for payment with the H409 and H410 fee codes.

COVID-19 Vaccination Services Rendered in Other Circumstances

When the COVID-19 vaccine becomes available for administration outside of hospital or public health unit (PHU) coordinated COVID-19 vaccination sites, the ministry will communicate billing instructions to physicians.

The Schedule of Benefits for Physician Services

The latest version of the Schedule of Benefits for Physician Services is available on the Ministry of Health website. Hard copies of the Schedule of Benefits for Physician Services will not be distributed. If you would like to order a paper copy or compact disk (CD) of the Schedule for a fee, please visit Publications Ontario. Physicians without access to the Internet can contact ServiceOntario at 1-800-668-9938.

This bulletin is a general summary

This bulletin is a general summary provided for information purposes only. Physicians are directed to review the Health Insurance Act, Regulation 552, and the schedules under that regulation, for the complete text of the provisions. You can access this information at ontario.ca/laws. In the event of a conflict or inconsistency between this bulletin and the applicable legislation and/or regulations, the legislation and/or regulations prevail.

Keywords/Tags

COVID-19, Vaccination, Vaccine, Immunization; H409; H410;

Contact Information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.

Find INFOBulletins online on the Ministry of Health website.

For More Information

Call ServiceOntario, Infoline at:
1–866–532–3161 (Toll–free)
In Toronto, (416) 314–5518
TTY 1–800–387–5559.
In Toronto, TTY (416)327–4282
Hours of operation: Monday to Friday, 8:30am – 5:00pm

 
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