Bulletin 230315 — Year 3 Increase: Special Premiums
Permanent adjustments of the Year 1 and Year 2 increases will be effective April 1, 2023.
To: All 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.
Palliative Care Special Premium Increase
Effective April 1, 2023, the Palliative Care Special Premium bonus will be increased by 20%.
- There are 2 threshold levels. Level 1 is for all eligible physicians including Patient Enrolment Models (PEMs) and Level 3 is for PEM eligible physicians only.
| Level | Annual Criteria | New Annual Bonus |
|---|---|---|
| 1 | 4 or more patients | $2,400 |
| 3 | 10 or more patients | An additional $3,600 for a total of $6,000 |
Long-Term Care Special Premium
Effective April 1, 2023, the Long-Term Care Special Premium bonus will be increased by 20%.
- There are 2 threshold levels. Level 1 is for all eligible physicians including PEMs and Level 3 is for PEM eligible physicians only.
| Level | Annual Criteria | New Annual Bonus |
|---|---|---|
| 1 | 12 or more patients | $2,400 |
| 3 | 36 or more patients | An additional $3,600 for a total of $6,000 |
Primary Care Serious Mental Illness Special Premium
Effective April 1, 2023, the Primary Care Serious Mental Illness (PC-SMI) Special Premium bonus will be increased by 20%.
- Only PEM physicians (except Comprehensive Care Model (CCM) physicians) are eligible for this premium, and only claims for patients enrolled to the billing physician are eligible for the PC-SMI premium.
- There are 2 threshold levels.
| Level | Annual Criteria | New Annual Bonus |
|---|---|---|
| 1 | 5 or more patients | $1,200 |
| 3 | 10 or more patients | An additional $1,200 for a total of $2,400 |
Office Procedures Special Premium Addition
Effective April 1, 2023, the new service ‘G552-Removal of intrauterine contraceptive device’ has been added to the list of services eligible towards the Office Procedures category.
The new service will accumulate towards the special premium when billed for enrolled patients by a physician in eligible models. When the service is provided by a nurse practitioner (NP) affiliated to a primary care model for an enrolled patient and submitted with the NP's six-digit OHIP identification number, the service will accumulate towards the service totals for the patient’s enrolled physician.
Keywords/Tags
Physician Services Agreement; PSA; physicians; payments
Contact information
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