Bulletin 230503 — K900A biosimilar support fee billing requirements
The K900A fee schedule code must be billed alone
To: OHIP Billing Software Vendors
Category: Billing Software Specifications
Written by: Claims Services Branch, Health Programs and Delivery Division
Date issued: May 15, 2023
The new Fee Schedule Code (FSC) ‘K900A - Biosimilar Support Fee’ must be billed alone (submitted separately from other Fee Schedule Codes) to ensure accurate processing.
The K900A Fee Schedule Code must be submitted alone on a claim to ensure payment. K900A is eligible for payment on the same date of service as other services, however, it must not be on the same claim.
Please ensure your application submits claims for K900A on a separate claim from any other service(s) to ensure payment.
K900A can only be provided under payment program Health Claims Payment (HCP), by a physician (OHIP billing number in the range of 000001 to 299999). Please reference INFOBulletin 230302 for further information on this code.
Biosimilar; Ontario Drug Benefit Program; ODB; Biologics; Exceptional Access Program; EAP; K900A