Permanent adjustments of the Year 1 and Year 2 increases will be effective April 1, 2023.

To: Group Health Centre (GHC) 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-Service (BFFS) premium payments will increase from 10% to 15% 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 2.6186%.

New Fee Schedule codes effective April 1, 2023

Effective April 1, 2023, the following new services have been introduced. The services when billed with a ‘C-Suffix’ have been added to the basket of ‘Excluded Codes’ for the Group Health Centre patient enrolment model.

Fee CodeDescription
E182CStrabismus procedures-Transposition of extraocular muscle to treat paretic or lost, damaged eye muscle
E183CStrabismus procedures-superior oblique muscle (per muscle)
E184CStrabismus procedures-inferior oblique muscle (per muscle)
E185CStrabismus procedures-horizontal or vertical rectus muscle (per muscle)
M112CSternal debridement and rewiring with or without special mechanical instrumentation-as sole procedure
N291CNerve transfer-major-(mixed sensory and motor nerve, or pure motor nerve)
N293CNerve transfer-minor-(sensory/cutaneous nerve)
R102CLevel 1 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy
R158CLevel 2 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy
R159CLevel 3 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy
R740CLeft atrial appendage occlusion/excision by suture or device, Sole procedure
Z516CExcision of first polyp (20 mm to 29 mm)
Z517CExcision of first polyp (10 mm to 19 mm)
Z518CExcision of first polyp (6 mm to 9 mm)
Z844CDiagnostic Paracentesis for: 1) suspected intraocular infection; 2) intraocular inflammation / uveitis; or 3) suspected cancer involving the intraocular structures or fluids

Deleted Fee Schedule codes Effective April 1, 2023

Effective April 1, 2023, the following services have been delisted and removed from the basket of ‘Excluded Codes’ for the Group Health Centre patient enrolment model.

Fee CodeDescription
E158CRetina and Extraocular Muscles-Repair-Strabismus procedures-Two muscles, one or both eyes
E159CStrabismus procedure one muscle one or both eyes
E162CStrabismus procedure-three or more muscles, one or both eyes
H400Emergency Department Sessional Fees-Sessions-Mon-Fri (other than holidays)-2000h-2400h
H401Emergency Department Sessional Fees-Sessions-Mon-Fri-Monday-Friday (other than holidays)-0000h-0400h
H402Emergency Department Sessional Fees-Sessions-Mon-Fri-Monday-Friday (other than holidays)-0400)-0400h-0800h
H403Emergency Department Sessional Fees-Sessions-Sat, Sun, Holidays-0000h-0400h
H404Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-0400h-0800h
H405Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-0800h-1200h
H406Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-1200h-1600h
H407Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-1600h-2000h
H408Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-2000h-2400h
R849CDialysis-Haemodialysis-Initial and acute (includes both medical and surgical components)
R850CDialysis-Haemodialysis-Surgical component alone-Insertion of Scribner shunt
Z408CBone marrow core biopsy (with biopsy needle)
Z450CDialysis-Revision of Scribner shunt-Single
Z451CDialysis-Revision of Scribner shunt-Both
Z570CIntestines (except rectum-)-Fulguration of first polyp through colonoscope

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.

Specialist services

Effective April 1, 2023, the base salary amounts for Fera Medical Professional Corporation physician specialists will be increased by the approved percentage for each specialty classification.  These increased payments will be reflected in your Monthly Transfer Payment as soon as possible.


Physician Services Agreement; PSA; physicians; payments

Contact information

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