Additional Information on the Acuity Modifier payments on the November 2025 Remittance Advice

To: Family Health Network (FHN) and Family Health Organization (FHO) Physicians
Category: Primary Health Care Services
Written by: Physician Relations and Contract Oversight Branch, Physician and Provider Services Division
Date issued: December 11, 2025
Bulletin Number: 251203

November 2025 Remittance Advice Payment Issue

Further to INFOBulletins 250901 and 251104, an acuity modifier payment issue under the “Network Base Rate Acuity Modifier Adjustment” accounting transaction resulted in incorrect acuity reconciliation on the November 2025 Remittance Advice (RA).

The ministry has remedied the root cause of the incorrect acuity reconciliation. FHN and FHO physicians and groups will see a reversal of the incorrect reconciliation under the “Network Base Rate Acuity Modifier Adjustment” accounting transaction on the December 2025 RA.

How to calculate November and December Acuity reconciliation

Physicians and groups can calculate the amount of the incorrect acuity reconciliation on their November RA by comparing the ‘Base Rate Acuity Adjustment’ accounting adjustment with the Base Rate Acuity Adjustment as reported on the Payment Summary Report:

Figure A: 

Screenshot of November RA Base Rate Acuity Adjustment Accounting Transaction

Figure B: 

November RA Physician Payment Summary Report

Example calculation:

  • For this example, the accounting adjustment reports an incorrect adjustment of -$504.95 (figure A).
  • The Payment Summary Report shows the correct acuity adjustment of -$0.93 (figure B).
  • Subtracting the value in figure B from the value in figure A results in the incorrect recovery amount: (-$504.95) – (-$0.93) = -$504.02 (Note: this incorrect recovery amount does not appear on the RA)

Physicians and groups can then calculate the amount of the incorrect acuity reconciliation reversal on their December RA by comparing the ‘Base Rate Acuity Adjustment’ accounting adjustment with the Base Rate Acuity Adjustment as reported on the Payment Summary Report:

Figure C: 

Screenshot of December RA Base Rate Acuity Adjustment accounting transaction

Figure D: December RA Physician Payment Summary Report

Screenshot of December RA Physician Payment Summary Report

Example calculation:

  • For this example, the accounting adjustment reports an adjustment of $503.50 to reverse the incorrect recovery (figure C).
  • The Payment Summary Report shows the correct acuity adjustment of -$0.52 (figure D).
  • Subtracting the value in figure D from the value in figure C results in the reversal of the incorrect recovery amount: ($503.50) – (-$0.52) = $504.02 (Note: this incorrect recovery reversal does not appear on the RA)

Keywords/Tags

FHN; FHO; Capitation; Acuity Modifier

Contact information

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