Bulletin 230603 — New Fee Code and changes to Hospitalist Premium criteria
Two key changes: a new fee code to remunerate Medical Certification of Stillbirth, and Schedule revisions related to Hospitalist Premiums
To: All Physicians
Category: Physician Services
Written by: Provider Services Branch; Physician and Provider Services Division
Date issued: June 30, 2023
Bulletin Number: 230603
The Ministry of Health and the Ontario Medical Association have been working together to implement the 2021 Physician Services Agreement. In accordance with the Physician Services Agreement (PSA) and based upon recommendations from the Physician Payment Committee (PPC), the following changes are being made to the Schedule of Benefits for Physician Services (the Schedule).
- A new fee code is being introduced related to the Medical Certification of Stillbirth.
- Schedule revisions related to the Hospitalist premium are being made.
New Fee Code for Medical Certification of Stillbirth
Effective July 1, 2023, the physician service of completing a Medical Certificate of Stillbirth (MCOS) is eligible for payment under fee codes A772 or C772.
A772 Certification of stillbirth - $20.60
C772 Certification of stillbirth – in-patient - $20.60
The C772 requires both a master number and an in-patient admission date for processing.
This service is payable to the physician who personally completes the Medical Certificate of Stillbirth. It includes any counselling of family members that is rendered at the same visit.
Please note, the OHIP / health card number of the patient experiencing the stillbirth must be used on the claim.
Changes to the Hospitalist Premium eligibility criteria
A revision is being made to the eligibility criteria of the 17% Hospitalist Premium within the May 26, 2023 Schedule edition (effective July 1, 2023) to reduce potential impacts on physicians taking pregnancy or parental leave.
The "Qualifying year" used to determine premium eligibility is now defined as:
[T]he fiscal year preceding the date of determination of eligibility except in cases where the physician has taken a pregnancy or parental leave during this period as confirmed by an application to the Pregnancy and Parental Leave Benefits Program. In such cases, "Qualifying year" means the most recent fiscal year not impacted by the leave.
This change is retroactively applicable to Hospitalist Premium payments made from November 1, 2021, onward. Adjustments to eligibility will be made by the ministry based on review of applications to the Pregnancy and Parental Leave Benefits Program (PPLBP). No action is required on the part of physicians. Further information about payment adjustments will be provided as the updates to eligibility occur.
Information about the PPLBP can be found in OHIP INFOBulletin 220405.
New Fee Code; Medical Certificate; Stillbirth; MCOS; Hospitalist; Pregnancy Leave; Parental Leave; PPLBP; Hospitalist premium; A772; C772
Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.