Bulletin 230328 — Year 3 Increase: GP Focused Practice — HIV
Permanent adjustments of the Year 1 and Year 2 increases will be effective April 1, 2023.
To: General Practitioner Focused Practice-HIV (GPFP-HIV) Physicians
Category: Primary Health Care Services, Physician Services
Written by: Negotiations Branch, Physician and Provider Services Division
Date issued: April 1, 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 premium payments will increase from 5% to 20% of the approved amount on all shadow-billed claims.
Base payment increase
Effective April 1, 2023, the following payment elements under your funding agreement will be increased by 11% and will be reflected on your May 2023 Remittance Advice (RA):
- Base Payment
Fee-For-Service threshold increase
Effective April 1, 2023, the Fee-For-Service billing limits for core services provided to non-enrolled patients will be increased by 3.3385%.
After-hours threshold increase
Effective April 1, 2023, the After-Hours Threshold will be increased by 3.3385%.
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 GPFP-HIV patient enrolment models.
| Fee Code | Description |
|---|---|
| H400 | Emergency Department Sessional Fees-Sessions-Monday-Friday (other than holidays)-2000h-2400h |
| H401 | Emergency Department Sessional Fees-Sessions-Monday-Friday (other than holidays)-0000h-0400h |
| H402 | Emergency Department Sessional Fees-Sessions-Monday-Friday (other than holidays)-0400-0800h |
| H403 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-0000h-0400h |
| H404 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-0400h-0800h |
| H405 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-0800h-1200h |
| H406 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-200h-1600h |
| H407 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-600h-2000h |
| H408 | Emergency Department Sessional Fees-Sessions-Saturday, Sunday, Holidays-2000h-2400h |
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 Q017A 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.
Keywords/Tags
Physician Services Agreement; PSA; physicians; payments
Contact information
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