Bulletin 260601 — PSA related fee schedule code adjustments: June updates
This bulletin contains updates to claim processing for J809 and Z901.
To: All Physicians, Integrated Community Health Services Centres
Category: Physician Services, Community surgical and diagnostic centres
Written by: Claims Services Branch, Health Programs and Delivery Division
Date issued: June 8, 2026
Bulletin Number: 260601
Overview
Further to INFOBulletin 260304, the Ministry of Health and the Ontario Medical Association are implementing permanent adjustments to physician payments effective April 1, 2026, as part of the 2024 Physician Services Agreement (PSA).
These adjustments are being added to the OHIP claims system through staged implementations. The following changes were implemented June 1, 2026, with an effective date of April 1, 2026.
| Fee schedule code | Description of change |
|---|---|
| J809 | Maximum services increased to 3. A stale-date exemption is in place for 3 months. |
| Z901 | Maximum services increased to 2. A stale-date exemption is in place for 3 months. |
J809 – Application of SPECT to J807 or J808
Effective April 1, 2026, the maximum number of eligible J809 services (for both the technical and professional components) has been increased to 3. This is to allow billing when both J808 and J807 are provided to the same patient on the same date of service by the same physician.
A stale-date exemption is in place for services provided on or after April 1, 2026. This exemption will end after August 2026.
Providers who have received the error ‘AM1 – Service Limit Exceeded’ on claims for J809 should resubmit the claim for processing.
As part of the phased implementation process, additional system changes are required to enable payment for J807 when billed with J809. Providers should continue to submit these claims as usual, but may see eligible claims appear with explanatory code ‘DF – Corresponding fee code has not been claimed or was approved at zero’. A medical claims adjustment will be completed at a later date to adjust payment for eligible claims.
Z901 – Irrigation of nasolacrimal system – per eye
As part of the April 1, 2026 update to the Schedule of Benefits, the description of Z901 was changed from “unilateral/bilateral” to “per eye”. The maximum number of eligible Z901 services has been updated to 2, to allow claims for each eye on the same date by the same physician for the same patient.
A stale-date exemption is in place for services provided on or after April 1, 2026. This exemption will end after August 2026.
Providers who have received the error ‘AM1 – Service Limit Exceeded’ on claims for Z901 should resubmit the claim for processing.
Keywords/Tags
PSA; Z901; J809; Schedule of Benefits; Stale-date; Eye; SPECT
Contact information
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