Education and Prevention Committee Billing Briefs

Education and Prevention Committee (EPC) Billing Briefs are prepared jointly by the Ministry of Health (MOH) and the Ontario Medical Association (OMA) to provide general advice and guidance to physicians on billing matters.

Category: Diagnostic Imaging (33); General Surgery (03); Obstetrics & Gynaecology (20); Otolaryngology (24); Anaesthesia (01); Family Medicine (00); Rehabilitation Medicine (31); Gastroenterology (41); Urology (35)  
Date of publication: March 6, 2026

Claims Tip: Fee code J069 has been clarified to specify its intended use and assist physicians in avoiding billing errors.

Focal thermal ablation

Focal thermal ablation is a minimally invasive method of focal tumour ablation that encompasses radiofrequency ablation (RFA) and microwave ablation.

J069 — Percutaneous focal thermal ablation of solid tumours using CT or Ultrasound guidance

  • The wording of J069 has recently been clarified in the Schedule of Benefits to assist physicians in the accurate use of this fee code.
  • J069 is only eligible for payment for focal thermal ablation of solid tumours (such as liver, kidney, lung) in patients meeting clinical criteria consistent with current clinical practice guidelines.
  • J069 includes any image guidance, when rendered, by any physician. Obtaining and interpreting any images in conjunction with J069 are not eligible for payment to any physician.
  • J069 is not eligible for payment for:
    • experimental therapies that are not supported by current clinical practice guidelines
    • thermal ablation of structures other than solid tumours
    • transcatheter arterial chemoembolization (TACE)
  • Physicians should consult Ontario Health/Cancer Care Ontario’s Focal Tumour Ablation in Ontario: Recommendations Report 2015 or subsequent guidelines to verify clinical indications for J069

Examples

Example 1: Hepatocellular carcinoma treatment

Dr. Aspen, an interventional radiologist, performs CT-guided radiofrequency ablation for an isolated early stage, biopsy-proven hepatocellular carcinoma 3 cm in diameter for a patient who is not a surgical candidate because of multiple co-morbidities.

What fee code(s) is/are eligible for payment to Dr. Aspen?

Explanation:

  • J069A is eligible for payment for image-guided radiofrequency ablation of this patient’s tumour by a physician.
  • No additional fee codes are eligible for payment to any physician for image guidance or CT interpretation performed in conjunction with the ablation procedure.

Example 2: Lung tumour treatment

Dr. Aspen treats a patient with two unresectable lung metastases (both lesions < 4 cm, one in each lung) with radiofrequency ablation.

What fee code(s) are eligible for payment to Dr. Aspen?

Explanation:

  • J069A x 2 is eligible for payment for image-guided radiofrequency ablation of this patient’s tumours by a physician.
  • No additional fee codes are eligible for payment to any physician for image guidance or CT interpretation performed in conjunction with the ablation procedure.

Example 3: Radiofrequency ablation of spinal nerves

Dr. Giroux, an anaesthesia specialist with a chronic pain practice treats a patient with facet joint-derived chronic low back pain with radiofrequency denervation of the right L4-5 and L5-S1 vertebral facet medial branches.

What fee codes are eligible for payment to Dr. Giroux?

Explanation:

  • N556A and E396A (Percutaneous vertebral facet medial branch or sacral lateral branch neurotomy – first and subsequent site) are eligible for payment for the two-level percutaneous vertebral facet neurotomies by a physician.
  • J069A is not eligible for payment for this procedure because it does not involve focal thermal ablation of a solid tumour.

Keywords/Tags

OHIP Claims; OHIP Payment; Focal Thermal Ablation; Solid Tumour; Radio Frequency Ablation; RFA; J069; N556; E396

Claims contact information

For additional information, please visit the Resources for physicians and the How to get help with billing questions pages on the ministry website.

If you have any billing or claims submission inquiries, please contact the Service Support Contact Centre (SSCC) by email at sscontactcentre.moh@ontario.ca or by calling 1-800-262-6524.

To provide feedback on EPC Billing Briefs, or to suggest topics for future EPC Billing Briefs, send an email to the attention of the joint Ministry of Health/OMA Education and Prevention Committee at info@oma.org.