Specialist consultation services referred by hospital-based dentists

To: All Physicians, Hospital-Based Dentists
Category: Physician Services, Dentist Services
Written by: Claims Services Branch; Health Programs and Delivery Division
Date issued: July 26, 2024
Bulletin Number: 240706

Overview

The Ministry of Health (ministry) is making changes to the Ontario Health Insurance Plan (OHIP) Schedule of Benefits for Physician Services (Schedule) to help streamline patient care and support scope of practice expansions.

Further to INFOBulletin 230706, the ministry has made changes to the OHIP claims system and claims for consultations requested by hospital-based dentists can be submitted for processing without flagging the claim for manual review.

Claims Submission

The claims payment system will now allow automated payment of specialist consultation services requested by hospital-based dentists rendered on or after July 1, 2023.

The service rendered by the specialist should be claimed using existing fee codes in the Schedule and include the OHIP billing number of the provider referring/ordering the service. The claim no longer needs to be flagged for manual review.

Keywords/Tags

Consultation; dentist; referral; OHIP; speciality codes

Contact information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524. Hours of operation: 8:00 a.m. to 5:00 p.m. Eastern Monday to Friday, except holidays.