Bulletin 260502 — 2024 PSA FHO Blended Fee-for-Service premium update
FHO Blended Fee-for-Service Premium has been increased from 30% to 50% effective April 1, 2026 for some fee codes.
To: All 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: May 15, 2026
Bulletin Number: 260502
Overview
The Ministry of Health and the Ontario Medical Association have been working together to implement a modernized Family Health Organization (FHO) model sometimes referred to as FHO+. In accordance with the 2024 Physician Services Agreement (PSA), additional funding has been allocated to increase the Blended Fee-for-Service Premium (BFFS).
Further to INFOBulletin 260308, specific in-basket services to enrolled patients will receive an additional 20% BFFS premium (for a total of 50%), beginning in May 2026 retroactive to April 1, 2026. Please see Appendix A for the list of services impacted.
Remittance advice (RA) reporting
The 20% premium will be included in the existing “BLENDED FEE-FOR-SERVICE PREMIUM’ accounting transaction along with the 30% premium paid for all in-basket services to enrolled patients
The Payment Summary Report will report all BFFS premiums paid to the physician. The new 20% BFFS premium will appear under ‘BLENDED FFS PREMIUM FOR FHO’:
The Blended Fee-For-Service Premium Summary Report will report all BFFS premiums paid to the physician as a single total:
The Blended Fee-For-Service Premium Detail Report will include a new section showing claims that received the additional 20% BFFS premium:
Medical Adjustments (MADJ)
The Blended Fee for Service premium has been adjusted to 50% on all eligible claims assessed in April 2026. Physicians will see these payments on their June 2026 remittance advice.
Appendix A
| Fee Schedule Code | FSC Descriptor |
|---|---|
| E542A | SKIN/SUBCUT TISSUE-INSERTION OF SUTURES OUTSIDE HOSP-ADD |
| G365A | D./T. PROC.-GYNAECOLOGY-PAPANICOLAOU SMEAR |
| G378A | D./T. PROC. GYNAECOLOGY-INSERTION OF IUD |
| G462A | Administration of oral polio vaccine |
| G538A | IMMUNIZATION - Other immunizing agents not listed above |
| G552A | D./T. PROC. GYNAECOLOGY-REMOVAL OF IUD |
| G840A | IMMUNIZATION - Diphtheria, Tetanus, and acellular Pertussis vaccine/ Inactivated Poliovirus vaccine (DTaP-IPV) – paediatric |
| G841A | IMMUNIZATION - Diphtheria, Tetanus, acellular Pertussis, Inactivated Polio Virus, Haemophilus influenza type b (DTaP-IPV-Hib) – paediatric |
| G842A | IMMUNIZATION - Hepatitis B (HB) |
| G843A | IMMUNIZATION - Human Papillomavirus (HPV) |
| G844A | IMMUNIZATION - Meningococcal C Conjugate (Men-C) |
| G845A | IMMUNIZATION - Measles, Mumps, Rubella (MMR) |
| G846A | IMMUNIZATION - Pneumococcal Conjugate |
| G847A | IMMUNIZATION - Diphtheria, Tetanus, acellular Pertussis (Tdap) – adult |
| G848A | IMMUNIZATION - Varicella (VAR) |
| R048A | SKIN-EXC.-LOC.MALIG.INCL.BIOPSY-FACE/NECK-1 LESION. |
| R051A | INTEG.SYST.SKIN-LASER SURG.ON GR.1 TO 4 MALIG.LESIONS |
| R094A | SKIN-EXC-SIMPLE-MALIG.LESION-OTHER AREA-INCL.BIOPSY-ONE. |
| Z101A | SKIN-INC.-ABSCESS-SUBCUT.-ONE -LOC.ANAES. |
| Z110A | INTEGUMENTARY SYST.EXTEN.DEBRIBEMT ONYCHOGRYPHOTIC NAIL |
| Z113A | INTEGUMENTARY SYST.BIOPSY(S)-ANY METHODSUTURES NOT USED |
| Z114A | SKIN-INC.-FOREIGN BODY-LOC. ANAES. |
| Z116A | SURG.PROC SKIN-BIOPSY(S)ANY METHOD WHEN SUTURES USED |
| Z117A | SKIN.CHEM/CRYOTHERAPY MINOR SKIN LESIONS 1/MORE |
| Z122A | SKIN-EXC.-GROUP 4-FACE/NECK-ONE LESION-LOC. ANAES. |
| Z125A | SKIN-EXC.-GROUP 4-OTHER AREAS-ONE LESION-LOC. ANAES. |
| Z128A | SKIN-DESTRUCTION FINGER/TOENAIL PART/COMP./NAIL PLATE EXC.1 |
| Z129A | SKIN-DESTRUCTION-FINGER/TOENAIL-SIMPLE-PART/COMPL.-MULTI |
| Z154A | SKIN-SUTURE LACER.-UPTO 5CM.-FACE-TIE BLEEDERS/LAYERS. |
| Z156A | SKIN-EXC-SUT.-BENIGN LESIONS-SINGLE. |
| Z157A | SKIN-EXC-SUT.-BENIGN LESIONS-TWO LESIONS. |
| Z158A | SKIN-EXC-SUT.-BENIGN LESIONS-THREE/MORE LESIONS. |
| Z159A | SKIN-& SUBCUT-REMOVAL BY ELECTROCOAG.-SINGLE LESION |
| Z160A | SKIN-& SUBCUT-REMOVAL BY ELECTROCOAG.-TWO LESIONS |
| Z161A | SKIN & SUBCUT.-REMOVAL BY ELECTROCOAG.-THREE/MORE LESIONS |
| Z162A | SKIN-EXC-SUT.-NAEVUS-ONE. |
| Z175A | SKIN-SUTURE LACER.-5.1CM-10CM.-OTHER AREA. |
| Z176A | SKIN-SUTURE-LACERATION-UPTO 5CM. |
| Z314A | NOSE-EPISTAXIS-CHEM/ELECTROCAUTERY-UNIL. |
| Z315A | NOSE-EPISTAXIS-ANTERIOR PACKING |
| Z535A | INTESTINES-ENDOSCOPY-SIGMOIDOSCOPY W/WITHOUT ANOSCOPY |
| Z543A | ANUS-ANOSCOPY |
| Z545A | ANUS-INC. THROMBOSED HAEMORRHOID |
| Z847A | EYE-CORNEA-INCISION-REM. SINGLE EMBEDDED FOREIGN BODY LOC. |
Keywords/Tags
Physician Services Agreement; PSA; physicians; FHO; Blended Fee-For-Service
Contact information
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