Bulletin 230305 — Physician and Hospital Services for Uninsured Persons Ending
March 31, 2023 is the end date for the temporary Physician and Hospital Services for Uninsured Persons (PHSUP) pandemic response funding.
To: All Physicians
Category: Physician Services
Written by: Health Insurance Branch, Health Programs Delivery Division
Date issued: March 29, 2023
Physician and Hospital Services for Uninsured Persons (PHSUP) funding ends March 31, 2023
The Ministry of Health (ministry) established PHSUP in March 2020 as a temporary, pandemic response measure. Its purpose was to help reduce the spread of COVID-19 by ensuring any uninsured persons (individuals without OHIP or other health insurance) in Ontario had access to medically necessary services. This was essential at a time when persons could not leave the province due to border closures and travel restrictions due to the emergency COVID pandemic response both nationally and internationally.
PHSUP provided temporary funding for the following:
- medically necessary services performed in hospital; and
- limited physician services performed in a community setting.
Following the general lifting of public health restrictions, Ontario continues to wind down COVID-19 response measures that are no longer appropriate or necessary.
COVID-19 vaccination for uninsured persons
Further to INFOBulletin 210601, the ministry has been issuing manual payments to physicians congruent with the relevant fee schedule codes associated with COVID-19 vaccine administration when rendering vaccination services to uninsured patients in a primary care setting. This manual payment process ends March 31, 2023. COVID-19 vaccinations rendered to uninsured persons with a service date on or after April 1, 2023 are uninsured and will no longer be eligible for payment.
Patients without an OHIP card
Please direct patients without an OHIP card to visit or call ServiceOntario at
Persons who are not eligible for OHIP and do not have any other form of health insurance coverage may obtain health services as they did pre-pandemic by paying for services directly or via private health insurance.
Additionally, uninsured persons continue to have limited access to the following publicly funded health care services:
- Primary care at Ontario’s Community Health Centres (75 sites across the province).
- Midwifery care (funded program; not dependent on OHIP coverage).
- Public Health Units (PHUs) may offer certain publicly funded vaccinations, testing for infectious diseases, and community harm reduction programs for uninsured persons.
- Health811 is also available as a resource to connect people with a registered nurse day or night for free, secure and confidential health advice. People can be directed to call
811(TTY: 1-866-797-0007) or go to ontario.ca/health811.
- Health811 can help patients find the Public Health Unit, Community Health Centre, and midwifery practices close to them.
- Emergency care: The Public Hospitals Act requires hospitals to admit uninsured patients if not doing so would endanger their lives.
Important billing timelines
- Hospitals will have 12 months from the date of service to submit PHSUP billing spreadsheets to the ministry for payment of hospital services provided to uninsured persons for service dates up to and including March 31, 2023. This is consistent with current program guidelines.
- Services provided after March 31, 2023, are not eligible for payment under PHSUP and hospitals should return to their own pre-pandemic billing practices for uninsured persons.
- Physicians will have 6 months from the date of service to submit claims for payment for the three temporary uninsured community fee codes (K087, K088, and K089) for services provided up to and including March 31, 2023.
- Services provided after March 31, 2023, are not eligible for payment.
Questions about Physician and Hospital Services for Uninsured Persons (PHSUP)
Please continue to direct any questions regarding payment of claims and/or the submission of claims to the ministry.
COVID; uninsured; OHIP; claims; reimbursement; vaccination