Relativity payment and reporting updates on the September 2025 Remittance Advice (RA)

To: All Physicians
Category: Physician Services, Primary Health Care Services, Community surgical and diagnostic centres 
Written by: Physician Relations & Contract Oversight Branch, Physician and Provider Services Division 
Date issued: September 17, 2025 
Bulletin Number: 250905

Overview

The Ministry of Health (ministry) and the Ontario Medical Association (OMA) have been working together to implement physician compensation increases in accordance with the Arbitration Award for year 1 of the 2024-2028 Physician Services Agreement (PSA).

Further to Bulletin 250406 — Relativity-adjusted physician payment increases updates were made to the OHIP claims system to apply relativity-adjusted (relativity) payments starting on the June 2025 Remittance Advice (RA). Relativity payments will be applied monthly on the same RA the corresponding payment is made (solo or group). The payment will appear as one of the following accounting adjustments:

  • HCP relativity payment
  • HCP relativity payment opt-out
  • RMB relativity payment
  • WSIB relativity payment

Reconciliation of previous payments

Further to the issues identified in Bulletin 250801 - Relativity Updates on the August 2025 Remittance Advice, reconciliation of previous payments for the April to June 2025 billing periods has occurred resulting in adjustments on the September 2025 RA. These adjustments will appear on the RA under one or more of the accounting adjustments listed above with a payment date of August 25, 2025.

However, the relativity summary report on the RA will still reflect the previous year-to-date (YTD) payments made at the incorrect relativity rate for the above billing period and will not include the amount paid or deducted under the accounting adjustment.

The ministry is investigating a solution to update the reporting on a future RA. Examples have been provided below to assist in payment verification for the September RAs while the solution for reporting is pending.

Examples of how the relativity accounting adjustment on the September RA can be verified

Until the September RA accounting adjustment can be included into the regular RA relativity reporting these steps can be followed to reconcile this payment. Groups receiving a payment will need to do this for each physician that was impacted by a change in derived specialty or who billed services that should have received the global relativity rate for the April to June billing period.

  1. Identify and sum up all payments received for the April to June billing period. Please note this information would need to be determined by reviewing payments in your claims billing software:
    • The value for all payments for:
      • Ministry of the Attorney General (MAG) services (K018A, K021A, and K061A)
      • Ministry of Children, Community and Social Services (MCCSS) services (K050A-K060A, K065A, and K066A)
    • The value for all office-based technical fees
      • hospital-based technical fees are not eligible for relativity payments and should be excluded
    • The value for all Community Palliative On-Call Coverage (CPOC) services (B400A)
    • The value for all remaining physician professional services and automated payments and premiums
      • Reciprocal Medical Billing System (RMBS) and Workplace Safety and Insurance Board (WSIB) claim amounts would also need to be separated from regular in-province (HCP) insured claims as those are paid under separate relativity accounting transactions
  2. Take the reported YTD value on the relativity summary report for your old/incorrect relativity rate and divide it by the decimal version of the relativity rate to determine the total payment amount for the April to June billing period.

Figure A:

Relativity Summary Report. Fiscal year April 1, 2025 - March 31, 2026

Example: $314.72 ÷ 0.104906 = $3,000.02

  1. Take the total payment amount calculated in step 2 and multiply it by the decimal version of the correct relativity rate (highlighted in the title row of the report) to determine the total correct relativity payment for the April to June billing period.

    Example: using Figure A above as an example, this physician only had professional or automated payments and premiums (as detailed in step 1above)

    • $3,000.02 x 0.127535 (individual physician’s relativity rate) = $382.61
  2. Subtract the total correct relativity payment calculated in step 3 from the reported YTD amount used in step 2. This total should match the relativity accounting adjustment.
    • $382.61 - $314.72 = $67.89 (noting some rounding discrepancies may exist when manually calculating)

Example 2: using a physician who has payments for both professional and technical fees eligible for relativity

Figure B:

Relativity Summary Report: Fiscal year April 1, 2025-March 31, 2026

Step 1: For this example, the breakdown of payments for the April to July billing period are $137,596.96 in technical fees, and $321,059.58 in professional fees and automated payments and premiums.

Step 2: $37,345.65 ÷ 0.081424 = $458,656.54

Step 3: Since there are multiple types of payments each receiving a different relativity rate, multiple calculations will be required:

  • Technical fees: $137,596.96 x 0.0996 (global rate of 9.96%) = $13,704.66
  • Professional fees: $321,059.58 x 0.065709 (individual physician’s relativity rate) = $21,096.50
  • Total correct relativity payment: $13,704.66 + $21,096.50 = $34,801.16

Step 4: $34,801.16 - $37,345.65 = -$2,544.49

This example results in a recovery of $2,544.49 for the April to June billing periods when applying the correct relativity rates.

Reporting issues resolved

The following reporting issues are now resolved.

  • The YTD totals on the OHIP Payment Summary Report will now correctly include the automated payment amounts for the April billing period that were paid via an accounting adjustment.
  • The relativity summary report on the RA will now display all payment amounts including the YTD payment amounts for automated payments when the month-to-date value is $0.00.

Keywords/Tags

2024-2028 PSA; Relativity; September 2025 RA; Derived Specialty; Global Rate; Tech Fees; CPOC; B400A; MCCSS; MAG

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.