Ontario Health Insurance Plan

INFOBulletin

Extension of Temporary COVID-19 Physician Services

Temporary OHIP physician services funding is being extended until September 30, 2022


To: All Physicians
Category
: Physician Services
Written by: Health Services Branch, Ontario Health Insurance Plan Division
Date issued: July 30, 2021
Bulletin Number: 210704


Temporary Physician Funding Related to COVID-19

To support patients continued access to health care as the government gradually reopens the province and rolls out the COVID-19 vaccine, the Ministry of Health (ministry) and the Ontario Medical Association (OMA) have reached an agreement to extend the existing temporary physician funding initiatives under the Ontario Health Insurance Plan (OHIP) to September 30, 2022, as outlined below.

In addition to the initiatives listed below, Temporary Physician Funding for Hospitals During COVID-19 has also been extended until September 30, 2022.

This INFOBulletin is intended to advise of the changes to support health system planning. The Schedule of Benefits for Physicians Services (Schedule) is being amended effective October 1, 2021 to reflect the changes listed below.

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, 2022.
  • Refer to INFOBulletin 210305 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, 2022.
  • Refer to INFOBulletin 210403 for details on this initiative.
  • NEW:  Effective October 1, 2021, K080, K081, K082, and K083 services rendered on or after October 1, 2021 will require a modality indicator tracking code to be submitted with the claim to identify the technology used to deliver the service: phone or video.
    • Additional information on submitting claims with a modality indicator tracking code will be provided in a future INFOBulletin.

Virtual Palliative Care Services

  • Continue the temporary OHIP virtual palliative care fee codes (K092, K093, K094, and K095) for palliative care physician services by phone and video until September 30, 2022.
  • Refer to INFOBulletins 210403 and 210605 for details on this initiative.

Focused Practice Psychotherapy Premium for Virtual Care

  • Continue the temporary payment of the focused practice psychotherapy premium with K082 psychotherapy services for eligible physicians until September 30, 2022.
  • Refer to INFOBulletin 210402 for details on this initiative.

Premiums and Management Fees for Virtual Care

  • Continue to enable the application of various premiums (Age-Based Fee Premiums, Internal Medicine Office Assessment Premium, E078, E060, K630, K187, K188, K189) and management fees (K045, K046, K119, K481, Q040, K682, K683, K684, W010) to the temporary virtual care K-codes until September 30, 2022.
  • Refer to INFOBulletin 210402 for details on the applicable premiums and management fees.
  • In addition, continue to enable the payment of point of care drug testing (G040, G041, G042 and G043) when done in association with a virtual K-code visit until September 30, 2022.
  • Refer to INFOBulletins 210402 and 210404 for details on point of care drug testing.

After Hours Procedure Premiums

  • Continue the temporary payment criteria for after-hours procedure premiums E409 and E410, including eligible elective surgeries and procedures, to September 30, 2022.
  • Refer to INFOBulletins 201110 and 210402 for details on the premiums.

Aerosol-Generating Medical Procedures (AGMP) Modifier Payments

  • Continue the temporary E404 modifier for AGMPs rendered outside of hospital until September 30, 2022.
  • Continue the temporary E405 modifier for AGMPs rendered in hospital until September 30, 2022.
  • Refer to INFOBulletin 210302 for details on these initiatives.

Critical Care Premiums

  • Continue the temporary E415 premium for life threatening critical care services (G521, G522 and G523) in lieu of hospital hourly Protective or Pre-Emptive Code Blue Teams funding, until September 30, 2022.
  • Refer to INFOBulletin 210303 for details on this premium.

Related INFOBulletin

A related INFOBulletin is available for all physicians. Read the "Extension of Temporary COVID-19 Physician Services".

Keywords/Tags

OHIP; Physicians; COVID-19; H409; H410; K080; K081; K082; K083; K092; K093; K094; K095; G040; G041; G042; G043; E409; E410; E404; 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

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TTY 1–800–387–5559.
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