Keeping Health Care Providers informed of payment, policy or program changes

To: Primary Health Care Services
Published by: Digital Health Division, Ministry of Health
Date Issued: March 19, 2020

On March 14, 2020 the ministry implemented temporary new fee codes that will enable physicians to be remunerated for provision of routine health care services over the telephone or through videoconferencing during the COVID-19 outbreak. The purpose of these codes is to provide physicians with increased flexibility to deliver care virtually, including but not limited to, assessment of COVID-19 symptoms, to help support efficient health care system flow during the outbreak.

The following information is intended to help provide clarity on how you should bill for video services during this time:

PhysicianTechnologyBilling Codes
Virtual Care Program members1 (e.g. current users of Ontario Telemedicine Network [OTN])Approved OTN video solutionOntario Virtual Care Program codes2
Virtual Care Program membersNon-approved OTN video solutionTemporary K codes
Non-Virtual Care Program membersAny video solutionTemporary K codes

1 The Virtual Care Program limits biling for video visits to patients in their location of choice (i.e. direct-to-patient video visits) to specialists, GP focused designation practice and primary care physicians in patient enrollment models serving rostered patients;

2 Temporary K codes can be used if preferred.

Further Information on the temporary K codes can be found here.

If you want to use the provincial videoconferencing service with verified privacy and security controls enabled by OTN, you can join OTN here.

Additional information regarding best practices for virtual care technology is provided below.

Video Solution - Technical Guidance

Physicians who are not using approved OTN video solution should review the following recommendations regarding video solutions.

Technical AspectRecommendations
ClinicalVideo solutions should enable:
  • Patient onboarding (e.g. registration, consent)
  • Scheduled and unscheduled video visits with patients and caregivers
  • Clinical users to manage the video visit (e.g. participant access)
  • Clinical users to share files and documents as needed
  • Transfer of virtual visit information to a medical or hospital record for clinical documentation or audit purposes (e.g. includes any files, images, messages or clinical notes exchanged during visit)
Image QualityVideo solutions should meet the minimum image quality requirements:
  • At a minimum, video solutions should support:
    • Minimum Resolution: 448p
    • Minimum Framerate: 15fps
  • High resolution and high framerate content sharing is recommended:
    • Minimum Content Resolution: 1024x768
    • Minimum Content Framerate: 5 fps
Privacy & SecurityVideo solutions should:
  • Enable secure access by patients through a registration process (e.g. login with password)
  • Prevent unauthorized entry to an ongoing virtual visit event
  • Support industry standard encryption for real-time communications (e.g. H.323: (H.235 for H.323 media encryption, AES)
    • SIP: (DTLS SRTP, TLS 1.2 or higher)
    • WebRTC: (DTLS SRTP)
  • Provide an audit trail of all virtual visit encounters
  • Vendor has an up-to-date Privacy Impact Assessment / Threat Risk Assessment
  • All personal health information held by systems located in Canada
Technical SupportVideo solution providers should:
  • Provide reasonable technical support to clinical users and patients
  • Contact information for technical support should be easily accessible by patients.

More details on this technical guidance is available at the OTN website.

Further Information

Questions

For billing related inquiries, please contact the Service Support Contact Centre at 1-800-262-6524.

Additional Resources

Ontario Health Quality, with support from OTN, has recently released draft clinical guidance on adopting and integrating virtual visits into care.

For detailed information on the Ontario Virtual Care Program virtual care remuneration see INFOBulletin # 4731.

For additional resources on delivering virtual care, visit the OTNhub Support.

For specific questions about conducting video visits, please contact: info@otn.ca.