Bulletin 211003 — Virtual Urgent Care Centres and Primary Care Outside Use
Virtual Urgent Care Centre services will be exempt from Outside Use effective October 1, 2021
To: Primary Care Physicians, Virtual Urgent Care Centres
Category: Physician Services, Primary Health Care Services
Written by: Negotiations Branch, OHIP, Pharmaceuticals and Devices Division
Date Issued: October 6, 2021
Temporary Physician Funding Related to COVID-19
To ensure patients continue to access health care as the government gradually reopens the province and rolls out the COVID-19 vaccine, the Ministry of Health (ministry) and the Ontario Medical Association (OMA) have reached an agreement to extend the existing temporary physician funding initiatives under the Ontario Health Insurance Plan (OHIP) to September 30, 2022, as outlined below.
Further to INFOBulletin #210704, this INFOBulletin is intended to advise of the changes to Primary Care outside use calculations from Virtual Urgent Care Centres (VUCC).
Virtual Urgent Care Centres and Enrolled Patients
Effective October 1, 2021, virtual care services billed from one of the pilot Virtual Urgent Care Centres (as defined by Ontario Health) for an enrolled patient will not contribute to the enrolling physician’s outside use and thus will not be deducted from their Access Bonus.
- The VUCC group range is 6A00 to 6A49
Physicians will submit for the following services provided to patients using their assigned group number while working for a Virtual UCC:
- K080A-COVID Telephone/Video Advice-10 minutes or less
- K081A-COVID Telephone/Video Advice-exceeds 10 minutes
- K082A-COVID Telephone/Video Advice-psychiatric care counselling/interview (per ½ hour)
- K300A-modality indicator (video)
- K301A-modality indicator (phone)
For information on the K300A/K301A modality indicators, please refer to INFOBulletin #210904.
All other services billed with a Virtual UCC group number will reject to the physician’s Error Report with the error ESF-NOT ELIG TO BILL FSC.
Physicians must submit for all services outside of the Virtual UCC with their solo billing number or other group billing number.
To register for a virtual urgent care centre billing group please complete the OHIP Group Registration for Health Care Professionals 002-84E form. The form should be completed by someone with signing authority at the hospital. On an empty space on the form please specify that you are creating a Virtual Urgent Care Centre group.
Once completed please return the form, direct deposit information for the group and your confirmation that you are eligible to participate in the Virtual Urgent Care Centre program to the Provider Registration team at:
Ministry of Health
Claims Services Branch
Provider Registry Unit
PO Box 68
Kingston, ON K7L 5K1
OHIP; Physicians; COVID-19; Access Bonus; Virtual Care; Virtual Urgent Care Centre