Bulletin 250306 — Updates on 2025-26 Ontario hospital interprovincial billing
Updates from the Ministry of Health on the new interprovincial billing rates for the 2025-26 fiscal year.
To: Chief Executive Officers, Hospitals
Category: Interprovincial health care
Written by: Hospitals Branch, Hospitals and Capital Division
Dates Issued: April 1, 2025
Bulletin Number: 250306
This INFOBulletin is a follow up to the memo sent to hospital Chief Executive Officers dated March 17, 2025, on this topic.
The new interprovincial billing rates for the 2025-26 fiscal year for outpatient and inpatient services, well newborns, high cost transplants, and special implants and devices are effective as of April 1, 2025. These new rates are outlined in further detail in the attachments.
The national Assistant Deputy Ministers Policy Advisory Committee has approved the interprovincial billing rates for these services.
Furthermore, Ontario hospitals will continue to submit Quebec outpatient claims using the revised combined outpatient billing rate sheet that includes physician compensation for non-invasive and diagnostic procedures through the Reciprocal Hospital Billing System for the 2025-26 fiscal year and onwards, until further notice.
Please forward this bulletin and its attachments to your hospital’s out-of-province billing department to ensure efficient processing of your hospital's reciprocal billing claims.
Should you have any further inquiries, need clarification regarding any of the information presented here, or be interested in obtaining a copy of the Ontario Hospital Reciprocal Billing Manual, please contact the ministry via e-mail at Hospitals.Branch-HSQFD@ontario.ca.
Attachments: Interprovincial Hospital Billing Rates for 2025-26 Fiscal Year
- 2025-26 Interprovincial Billing Rates for Outpatient Services, effective for visits on or after April 1, 2025
- 2025-26 Interprovincial Billing Rates for Outpatient Services provided in Ontario for Quebec residents on or after April 1, 2025
- 2025-26 Ontario hospital interprovincial per diem rates for inpatient services, effective April 1, 2025
- Services excluded under the Canadian Interprovincial Agreements for Reciprocal Processing of Out-of-Province Hospital Claims
- Valid Insured Health Services Plan Cards for Reciprocal Billing
- 2025-26 Rates for services for Well Newborns provided on or after April 1, 2025
- 2025-26 Rates for High Cost Transplants, effective for discharges on or after April 1, 2025
- 2025-26 Rates for Special Implants and Devices Add-ons, effective for interventions on or after April 1, 2025
Keywords/Tags
Interprovincial Billing
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