Ontario Health Insurance Plan

INFOBulletin

COVID-19 Temporary Physician Funding

Temporary OHIP physician services funding is being extended and enhanced


To: All Providers
Category: Physician Services
Written by: Health Services Branch, Ontario Health Insurance Plan Division
Date issued: March 8, 2021
Bulletin Number: 210304


Temporary Physician Funding Related to COVID-19

To ensure patients continue to access the heath care they need through the second wave and the roll-out of the COVID-19 vaccine in Ontario, the Ministry of Health (ministry) and the Ontario Medical Association (OMA) have reached an agreement to extend five existing temporary physician funding initiatives under the Ontario Health Insurance Plan (OHIP) to September 30, 2021 and November 28, 2021, as outlined below. In addition to the initiatives listed below, the temporary physician funding for hospital-based physicians has also been extended until September 30, 2021.

The ministry and OMA have also agreed to introduce two new temporary physician funding initiatives for the period of March 14, 2021 to September 30, 2021, and one new temporary physician funding initiative for the period of October 1, 2020 to September 30, 2021, as outlined below.

This INFOBulletin is intended to advise of the changes to support health system planning. Further INFOBulletins will be forthcoming to provide details on the initiatives.

Existing Initiatives Being Extended

The ministry is extending the following existing temporary physician funding initiatives:

  • Assessment Centres (ACs)
    • Continue the H409 and H410 sessional fees for physicians providing COVID-19 services at ministry-designed ACs to September 30, 2021.
    • Refer to INFOBulletins 4745 and 4747 for details on this initiative.

  • Virtual Care (“K-Codes”)
    • Continue the temporary OHIP virtual care fee codes (K080, K081, K082, and K083) for physician phone and video visits until September 30, 2021.
    • Refer to INFOBulletin 4745 for details on this initiative.

  • Premiums and Management Fees for Virtual Care
    • Continue to enable the application of various existing premiums and management fees that relate to in-person visits to the temporary virtual care K-codes until September 30, 2021.
    • Refer to INFOBulletin 4764 for details on the applicable premiums and management fees.
    • In addition, enable the payment of point of care drug testing urine tests (G040, G041, G042 and G043 fee codes) when done in association with a virtual visit.

  • After Hours Premiums
    • Continue the temporary payment criteria for after hours procedure premiums E409 and E410 to November 28, 2021.
    • Refer to INFOBulletin 201110 for details on the premiums.

  • AGMP Modifier Payments
    • Reactivate the E405A COVID Hospital Complexity Modifier for AGMPs in hospital retroactive to October 1, 2020 and until September 30, 2021.Refer to INFOBulletins 4758 and 201108 for details on these initiatives.

New Initiatives

The ministry is also introducing some new temporary physician funding initiatives:

  • Focused Practice Psychotherapy Premium for Virtual Care
    • Enable the application of the existing focused practice psychotherapy premium for eligible physicians that relates to in-person psychotherapy to psychotherapy provided by phone or video using the K082 virtual care K-code for the period of March 14, 2021 to September 30, 2021.

  • Virtual Care for Palliative Care
    • New temporary OHIP virtual care fee codes specifically for palliative care physician services by phone and video, at equivalent rates to A945 and K023, are being created for the period of March 14, 2021 to September 30, 2021.

  • Critical Care Premiums
    • Introduce a new COVID-19 temporary 30% premium (E415A) for life threatening critical care services G521, G522 and G523, in lieu of hospital hourly Protective or Pre-Emptive Code Blue Teams funding, for the period of October 1, 2020 to September 30, 2021.

Fee codes K080A, K081A, K082A, K083A, K084A, G040A, G041A, G042A, G043A, E405A, E404A and E415A are exempt from stale date processing until June 30, 2021.

Additional INFOBulletins will be released by the ministry in order to provide more detailed information on these initiatives.

Keywords/Tags

OHIP; Physicians; COVID-19; H409; H410; K080; K081; K082; K083; G040; G041; G042; G043; E409; E410; E405; E415;

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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