Bulletin 260311 — Physician Services Agreement – Targeted Funding, Anaesthesia Stipend

To: All Physicians and Hospitals
Category: Physician Services
Written by: Provider Services Branch
Date issued: April 1, 2026
Bulletin Number: 260311

New tiered daily anaesthesia stipend

The Ministry of Health and the Ontario Medical Association have been working together to implement the 2024 Physician Services Agreement (PSA). The PSA provides for a targeted investment in anaesthesia to be implemented as a daily stipend for in-hospital anaesthesia services.

Effective April 1, 2026, qualifying anaesthesia providers will be eligible to receive a tiered daily stipend for time spent delivering qualifying scheduled anaesthesia services in hospital settings. This stipend is supplementary and does not replace or reduce existing physician payments.

This INFOBulletin describes the structure and eligibility criteria of the stipend as well as the mechanism by which the stipend will be paid.

Stipend structure and amount

• The daily anaesthesia stipend will follow the tiered structure described at Appendix A
• The payment tier is determined by the total number of eligible hours worked per service date, rounded to the nearest hour, to a maximum of $440 per eligible provider per eligible service date
• Only one stipend claim is eligible for payment per eligible service date, per eligible provider

Eligibility

Eligible physicians:

• Anaesthesiologists (OHIP Billing Designation '01')
• Family Practice Anaesthetists (OHIP Billing Designation '00')

Eligible locations:

• Ontario public hospitals where operative and/or procedural services are rendered requiring anaesthesia support
  • For clarity, this does not include off-site premises operated by hospital corporations under section 4(2) of the Public Hospitals Act

Eligible services:

• Direct provision of in-person anaesthesia services and/or on-site supervision of the following in-person anaesthesia services (including when the provider is onsite and scheduled and available to provide such services):
  • Peri-operative care
  • Operative procedures
  • Non-Operating Room Anaesthesia activities: administration of anaesthesia or sedation for procedures outside of a traditional operating room setting (example: endoscopy, radiology, obstetrics, cardiac catheterization, electrophysiology, electroconvulsive therapy)
• Excludes time spent:
  • Engaged in activities that are not described above (example: coverage of intensive care units, chronic pain clinics, sleep labs)
  • Performing dedicated teaching, research, leadership, administrative responsibilities
  • Rendering uninsured services
  • During meal or other break periods where the physician is not available to provide the services

Eligible hours:

• Scheduled weekday hours (Monday to Friday) between 7:00 a.m. and 5:00 p.m., excluding periods eligible for After Hours Premiums (E400C or E401C)

Payment mechanism

• The stipend will be paid through the OHIP claims payment system using a dedicated fee code (to be announced)
• Physicians will submit one claim per eligible service date with the service quantity reflecting the payment tier achieved based on the total eligible hours worked

Implementation timeline

• Although the effective date of the anaesthesia stipend is April 1, 2026, the OHIP claims payment system will not be ready to accept stipend claims on this date
• Physicians should begin maintaining records of all eligible stipend hours worked beginning April 1, 2026, including:
  • Date of service
  • Location of service (example: the hospital where the scheduled anaesthesia hours were worked)
  • Number of eligible hours worked
• Claims will be submitted once system changes have been completed
• Additional guidance, including the new fee code and detailed claims submission instructions, will be communicated as implementation progresses

Appendix A: Tiered anaesthesia stipend rates

Note: the payment tier corresponds to the number of eligible hours provided by an eligible provider on an eligible service date, rounded to the nearest hour (with 0.5 rounded up). For clarity, eligible periods of time accumulated throughout the service date must be aggregated prior to rounding. For example:

• Correct: 2.6 hours in the a.m. + 3.7 hours in the p.m. = 6.3 hours (payment Tier 6)
• Incorrect: 2.6 hours in the a.m. + 3.7 hours in the p.m. = 3 hours + 4 hours (payment Tier 7)

Keywords/Tags

Physician Services Agreement; PSA; Targeted Investment; Anaesthesia; Stipend

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.