Certain temporary COVID-19 physician services funding ends on March 31, 2023

To: All Physicians
Category: Physician Services
Written by: Provider Services Branch; Physician and Provider Services Division
Date issued: March 29, 2023

Temporary physician funding related to COVID-19

As previously communicated in INFOBulletin 220904, specified temporary physician funding initiatives under the Ontario Health Insurance Plan (OHIP) will be ending effective March 31, 2023, as outlined below.

This INFOBulletin is intended to advise of the changes to support health system planning.

Existing initiatives being ended

The ministry is ending the following temporary physician funding initiatives:

Aerosol-Generating Medical Procedures (AGMP) modifier payments

  • Both AGMP fee schedule codes, E404 (outside of hospital) and E405 (in hospital), will end on March 31, 2023.
  • Providers will have 6 months from the date of service to submit claims for E404 and E405 for services provided on a date up to and including March 31, 2023.
  • Claims for E404 or E405 with a service date after March 31, 2023 will reject to the error report with error code A3E-‘No such service code for date of service’.
  • Refer to INFOBulletin 210302 for details on these initiatives.

Life threatening critical care premiums

  • Fee schedule code E415 will end on March 31, 2023.
  • Providers will have 6 months from the date of service to submit claims for E415 for services provided on a date up to and including March 31, 2023.
  • Claims for E415 with a service date after March 31, 2023 will reject to the error report with error code A3E-‘No such service code for date of service’.
  • Refer to INFOBulletin 210303 for details on this premium.

Temporary physician funding for hospitals during COVID-19

Funding for the following components under the Temporary Physician Funding for Hospitals During COVID-19 framework will cease effective March 31, 2023:

  1. Intensive Care Units
  2. Ward Care
  3. Protected or Pre-Emptive Code Blue Team
  4. Administrative Non-Clinical Assignments
  5. Infectious Disease Hospital Specialists
  6. Residents on Restricted Registration Certificates

Given the ending of this funding, no payments will be processed for any of the above noted funding components for service dates after March 31, 2023.

Please be advised that any remaining requests for payments from hospitals for the above noted components should only be for costs that hospitals have incurred under the Temporary Hospital Physician Funding for service dates on or before March 31, 2023.

Keywords/Tags

OHIP; Physicians; COVID-19; E404; E405; E415.

Contact information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.