Bulletin 230313 — Year 3 Increase: Family Health Network and Family Health Organization
Permanent adjustments of the Year 1 and Year 2 increases will be effective April 1, 2023.
To: Family Health Network (FHN) Physicians, Family Health Organization (FHO) Physicians
Category: Primary Health Care Services, Physician Services
Written by: Negotiations Branch, Physician and Provider Services Division
Date issued: March 31, 2023
The Ministry of Health and the Ontario Medical Association have been working together to implement physician compensation increases in accordance with the 2021 Physician Services Agreement (PSA).
The PSA provides for Year 1 and Year 2 compensation increases to be implemented as permanent adjustments to physician payments effective April 1, 2023. The permanent increase amounts vary according to relativity as outlined in the PSA. They are allocated to each section or physician grouping, as per page 6 of the Financial Agreement of the PSA.
Blended Fee-For-Service (BFFS) premium increase
Effective April 1, 2023, Blended Fee-For Services (BFFS) premium payments will increase from 15% to 19.41% of the approved amount on all shadow-billed claims.
Hard Cap threshold increase
Effective April 1, 2023, the Fee-For-Service billing limits for core services provided to non-enrolled patients (the Hard Cap) will be increased by 1.7817%.
New Fee Schedule Codes effective April 1, 2023
Effective April 1, 2023, the new ‘K133A-Periodic Health Visit for Adults with Intellectual and Developmental Disabilities’ has been introduced. The new service has been added to the basket of ‘Included Codes’ for the FHN and FHO patient enrolment models for both regular and Long-Term Care patients.
Effective April 1, 2023, the new ‘G552-Removal of intrauterine contraceptive device (IUD)’ has been introduced. The new service has been added to the basket of ‘Included Codes’ for the FHO patient enrolment model for regular patients only.
New service eligible for after-hours
Effective April 1, 2023, the new service ‘K133A-Periodic Health Visit for Adults with Intellectual and Developmental Disabilities’ is eligible for the after-hours premium when billed with a Q012A for enrolled patients.
Fee Schedule Code increases effective April 1, 2023
Effective April 1, 2023, the Fee Schedule Master (FSM) will be updated to reflect new values for fee-for-service (FFS) codes as agreed to between the ministry and the OMA at the Physician Payment Committee (PPC). For more information, please see INFOBulletin 230310.
Physician Services Agreement; PSA; physicians; payments