Bulletin 210405 — Increases to physician laboratory medicine fees — Kaplan Award
Year 4 compensation increases for laboratory medicine fee codes to be paid on May 2021 Remittance Advice (RA)
To: Laboratory Medicine Physicians
Category: Physician Services
Published by: Claims Services Branch, Ontario Health Insurance Plan Division
Date Issued: April 23, 2021
Background
Further to INFOBulletin #210306, the Medical Claims Adjustment (MADJ) for the retroactive increases to Physician Laboratory Fees is being processed. This will be completed in April for payment on the May 2021 Remittance Advice (RA).
Retroactive increases to physician laboratory fees
The fee codes below were retroactively increased effective April 1, 2020. Adjustments to these codes will be reported on the May 2021 RA.
| Fee code | Previous value | New value |
|---|---|---|
| L800A | $21.70 | $22.70 |
| L805A | $81.20 | $83.85 |
| L806A | $35.80 | $36.20 |
| L810A | $23.40 | $25.00 |
| L820A | $7.00 | $8.15 |
| L826A | $13.35 | $15.15 |
| L829A | $13.70 | $14.65 |
| L834A | $13.35 | $15.15 |
| L835A | $13.35 | $15.15 |
| L841A | $13.35 | $15.15 |
| L843A | $21.50 | $23.55 |
| L844A | $13.60 | $14.55 |
| L846A | $12.20 | $12.60 |
| L849A | $13.90 | $15.20 |
| A585A | $68.60 | $73.30 |
| C585A | $64.70 | $73.30 |
Medical Claims Payment Adjustment
All fee schedule codes in the table above submitted with service dates between April 1, 2020 and March 31, 2021 will be adjusted to pay at the new value.
Claims that have been adjusted will show up on the RA with explanatory codes ’55-This deduction is an adjustment on an earlier account (system generated negate)’ and ’57-This payment is an adjustment on an earlier account’. The difference in payment will equal the difference between the old and new fee code amounts.
Keywords/tags
Kaplan Award; Arbitration; Year 4; MADJ; Laboratory Medicine
Contact information
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