Bulletin 4750 — Virtual Care Program — New Virtual Care Billing Codes Effective (April 1, 2020)
Keeping health care providers informed of payment, policy or program changes
To: All Physicians
Published by: Health Services Branch, Ministry of Health
Date Issued: March 25, 2020
The Ontario Virtual Care Program (previously called the Telemedicine Program) has now issued new billing codes for Hosted Video Visits and Direct-to-Patient Video Visits, which provide futher detail on the Virtual Care Program changes announced on November 15, 2019, INFOBulletin 4731.
This bulletin does not relate to the temporary new fee codes (K codes), announced on March 14, 2020, for the provision of routine health care services over the telephone or through videoconferencing during the COVID-19 outbreak, INFOBulletin 4745.
Tracking fee codes
$0.00 Hosted video visit - patient attending at a patient host site
- Synchronous video visits with a patient who is physically located and supported at a patient host site during the clinical encounter.
$0.00 Direct-to-Patient Video Visit
- Synchronous video visits with a patient in the home or another location of their choice (i.e. the patient is not at a patient host site).
All previous Virtual Care Program B-codes have been discontinued as of April 1, 2020. Claims are submitted with the appropriate Virtual Care Program B-code, Ontario Health Insurance Plan (OHIP) Schedule of Benefit service fee code and Service Location Indicator (SLI) set to "OTN". Physicians/dentists are paid on par to in-person care for services delivered via video visit.
Disclaimer: Virtual care services covered by the Ontario Virtual Care Program are not insured under the Health Insurance Act (HIA) and thus if physicians/dentists submit claims without a Virtual Care Program B-code and SLI codes set to "OTN" the ministry will recover any amounts paid by OHIP.
In order to maintain patient access to care during this transition period for the Virtual Care Program:
- Physicians/dentists delivering Hosted Video Visits to rural patients will continue to receive a $15.00 premium payment per completed Hosted Video Visit for 1 year (i.e. until March 31, 2021) to allow for a longer transition phase for those providing Hosted Video Visits to rural patients. This payment will be delivered as batch payments, which means that B103A will pay at $0.00, but there will be periodic payments of the premium to physicians/dentists. Further details to follow.
- Physicians/dentists feedback submitted to the Ministry-OMA Virtual Care Working Group1 through the Telemedicine Premium Removal Feedback Form (November 15, 2019-January 24, 2020) informed consideration of further mitigation. Physicians/dentists who provided feedback will have received communication by e-mail from the ministry or their OMA section before April 1, 2020 regarding the outcome of this process.
For general questions about the Ministry-OMA Virtual Care Working Group's process to expanding virtual care in the province, please contact: email@example.com.
- All Virtual Care Program INFOBulletins
- For further billing details see the Virtual Care Billing Information Manual.
- To sign up for virtual care services through OTN visit the OTNhub Sign Up page.
- To be eligible to conduct video visits and to register for billing via the OHIP claims system please see the OHIP Virtual Care Physician & Dentist Registration Form.
For additional resources on delivering virtual care, visit the OTNhub Support.
Ontario Health Quality, with support from OTN, has recently released draft clinical guidance on adopting and integrating virtual visits into care.
The Virtual Care Working Group was struck earlier this year between the Ministry and the Ontario Medical Association (OMA), with participation by OntarioMD and OTN to further explore expansion of virtual care in Ontario.