Bulletin 230323 — Year 3 Increase: Rural and Northern Physician Group Agreement
Permanent adjustments of the Year 1 and Year 2 increases will be effective April 1, 2023.
To: Rural and Northern Physician Group Agreement (RNPGA) Physicians-Groups 1 & 2
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, BFFS premium payments will increase from 5% to 9.65% of the approved amount on all shadow-billed claims.
New services 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.
Effective April 1, 2023, the new service ‘G552-Removal of intrauterine contraceptive device (IUD)’ will pay Fee-For-Service (FFS) when billed with a Q022A where eligible.
Effective April 1, 2023, the following new services when billed with a ‘B-Suffix’ or ‘C-Suffix’ will pay FFS when billed with the Q022A where eligible:
| Fee Code | Description |
|---|---|
| Z844 | Diagnostic Paracentesis for: 1) suspected intraocular infection; 2) intraocular inflammation / uveitis; or 3) suspected cancer involving the intraocular structures or fluids |
| Z518 | Excision of first polyp (6 mm to 9 mm) |
| E520 | Excision of each additional polyp (6 mm to 9 mm) |
| Z517 | Excision of first polyp (10 mm to 19 mm) |
| E519 | Excision of each additional polyp (10 mm to 19 mm) |
| Z516 | Excision of first polyp (20 mm to 29 mm) |
| E518 | Excision of each additional polyp (20 mm to 29 mm) |
| R102 | Level 1 oncoplastic breast conserving lumpectomy or
partial mastectomy for malignancy |
| R158 | Level 2 oncoplastic breast conserving lumpectomy or
partial mastectomy for malignancy |
| R159 | Level 3 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy |
| R740 | Left atrial appendage occlusion/excision by suture or device, Sole procedure |
| Z352 | Intrapleural administration of thrombolytic or fibrinolytic agent via thoracostomy tube (chest tube) |
| Z363 | Removal of thoracostomy tube (chest tube) |
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.
Keywords/Tags
Physician Services Agreement; PSA; physicians; payments
Contact information
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