Temporary increase to facility fee payments – now permanent

To: Independent Health Facilities
Category: Independent Health Facilities
Written by: Health Insurance Branch, Health Programs and Delivery Division
Date issued: April 1, 2023

New: Physician Services Agreement changes effective April 1, 2023

The Ministry of Health and the Ontario Medical Association have been working together to implement physician compensation changes agreed to under the 2021 Physicians Services Agreement (PSA).

Facility Fee Values effective April 1, 2023

As part of the implementation of the latest Physician Services Agreement, all facility fee services provided in licensed independent health facilities paid on a fee-for-service basis will continue to pay at the 2.01% increased rate applied April 1, 2022.

New: Fee Schedule Code Revision

Revisions to the fee schedule code below are now in effect for services rendered from April 1, 2023 onward.

Specific wording clarifying clinical scenarios where code J167 is eligible for payment has now been added.

Fee Schedule CodeFee Schedule Code DescriptionRevision Description
J167Fetal Doppler evaluation of middle cerebral artery and/or ductus venosus, to J160 or J158Payment Rules Revised (eligible clinical scenarios clarified)

Update your billing software

Please ensure that your billing software is updated to reflect the new Fee Schedule Code values for any services rendered on or after April 1, 2023, before submitting your claims.

The updated Fee Schedule Master can be found on the Ministry of Health website.

This file will be available for download by April 6, 2023

Keywords/Tags

Physician Services Agreement; PSA; Independent Health Facilities; facility fees; payments

Contact information

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