Ontario Health Insurance Plan

INFOBulletin

Temporary increases for facility fees for April 1

The ministry will temporarily increase physician payments by 2.01% for the period April 1, 2022 to March 31, 2023.


To: Independent Health Facilities
Category: Independent Health Facilities
Written by: Claims Services Branch; OHIP, Pharmaceuticals and Devices Division
Date issued: April 1, 2022
Bulletin Number: 220402


Physician Services Agreement Initiatives Effective April 1, 2022

The Ministry of Health and the Ontario Medical Association have been working together to implement physician compensation increases in accordance with the 2021 Physician Services Agreement.

Year 2 (2022-2023) of the Agreement provides for a lump sum payment that will be applied as a temporary 2.01% global increase to the value of Fee Schedule Codes (FSCs) for physician services rendered between April 1, 2022 and March 31, 2023. This will be achieved through an update to the Fee Schedule Master (FSM).

Premium and add-on Fee Schedule Codes

Premium and add-on FSCs that pay a percent increase have not been changed but will calculate the premium payments using the increased fee approved value of the accompanying eligible service(s).

Tables showing Fee Schedule Code increases

Tables showing the applicable FSC increases are available with this INFOBulletin.

Update your billing software

Please ensure that your billing software is updated to reflect the new FSC values for any services rendered on or after April 1, 2022.

The updated Fee Schedule Master can be found on the Ministry of Health website. This file will be available for download by April 7, 2022.

Claims processed through the OHIP claims system with a service date between April 1, 2022 and March 31, 2023 will reflect these increases and will be reported on your Remittance Advice (RA).

Reciprocal Medical Billing (RMB)

Payments made through the RMB payment program, and any associated premiums, are not eligible for the 2.01% increase.
Due to staged implementations, Medical Claims Adjustments (MADJ) may be required to reprocess and adjust RMB claims to the eligible rate.

Further information will be provided in advance of a MADJ.

Keywords/Tags

FSM; payments; facility fees; physicians; Physician Services Agreement; PSA; fee schedule master

Contact Information

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

For More Information

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TTY 1–800–387–5559.
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