Bulletin 260802 — Physician Services Agreement – Update on Anaesthesia Stipend

To: All Physicians and Hospitals
Category: Physician Services
Written by: Provider Services Branch
Date issued: August 4, 2026
Bulletin Number: 260802

New fee code for tiered daily anaesthesia stipend

The Ministry of Health (the ministry) 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.

As described in OHIP INFOBulletin 260311, qualifying anaesthesia providers are eligible to receive a tiered daily stipend for time spent delivering qualifying scheduled anaesthesia services in hospital settings, effective April 1, 2026.

Effective August 3, 2026, a new fee code has been added to the medical claims payment system to enable submission of anaesthesia stipend claims. Physicians may now submit anaesthesia stipend claims for services dates April 1, 2026 onward.

New Fee Code

H010A — Anaesthesia Stipend Unit

One unit represents one eligible hour of service

Stipend structure and amount

1. The daily anaesthesia stipend is payable according to the tiered structure described at Appendix A
2. The payment tier is determined by the total number of eligible hours worked per service date, rounded to the nearest hour

Eligibility

Determining whether a period of work is eligible for the anaesthesia stipend involves assessing whether all four of the following criteria have been met:

1. Physician Eligibility:
   • Anesthesiologists (OHIP Billing Designation ‘01’)
   • Family Practice Anesthetists (OHIP Billing Designation ‘00’)
2. Location Eligibility:
   • 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
3. Service Eligibility:
   • 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 (e.g. endoscopy, radiology, obstetrics, cardiac catheterization, electrophysiology, electroconvulsive therapy)
   • Excludes time spent:
     • Engaged in activities that are not described above (e.g., 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.
4. Date and Time Eligibility
   • Scheduled weekday hours (Monday to Friday) between 7:00 a.m. and 5:00 p.m.
   • Excludes periods eligible for After Hours Premiums (E400C or E401C)

Claim submission requirements

• One H010A claim should be submitted per physician for each service date on which eligible stipend hours were worked.
• The service quantity entered on the claim must reflect the total number of eligible stipend hours accumulated on the respective date of service
• H010A must be billed with the unique anaesthesia stipend group number assigned to the location of service delivery (see below for further details)
• It is important to remember that anaesthesia stipend group numbers are different from other anaesthesia group billing numbers that physicians may currently be using
  • Anaesthesia stipend group numbers must only be submitted on claims for H010A. Claims for all other services should continue to be submitted in accordance with the physician’s existing manner
  • If a claim for any fee code other than H010A is submitted with an anaesthesia stipend group number, payment of those claims may be adversely impacted
  • If a claim is for H010A is submitted with any group number other than an anaesthesia stipend group number, the claim will not be accepted for payment
• In circumstances where eligible hours were accumulated at more than one location, the unique anaesthesia stipend group number of the location where most hours were worked should be entered on the claim
• H010A must be billed with a blank health number, blank version code, and blank date of birth (no zeroes or spaces in that field).

Claims submission cutoff dates

• A stale-date exemption is in place to ensure that all eligible stipend services rendered on or after April 1, 2026 can be submitted.

Anesthesia stipend group affiliation requirements

• H010A claims must be submitted with the anaesthesia stipend group number assigned to the location of service delivery. This is a four-digit alphanumeric field that begins with the character ‘E’ (e.g., Exxx)
• Only physicians affiliated to the respective anaesthesia stipend group will be able to submit H010A claims for services rendered at the corresponding location
• Initial anaesthesia stipend group numbers were established following information collected from eligible hospitals
• Physicians may wish to speak with their anaesthesia service head to confirm the anaesthesia stipend group number(s) for locations where they have rendered eligible services
• Physicians who joined an anaesthesia service after initial group registrations were completed will need to be affiliated to the group number before they are able to submit claims
• To add a new member to an existing anaesthesia stipend group, complete the “Consent and Authorization for Group Membership and Payment” form through the web-based application service, available at: Provider Registration or Change Request.

Payment

Anaesthesia stipend payments are being implemented in a staged manner as system programming is completed.

Stipend amounts for service dates from April 1, 2026, to March 31, 2027, will be manually processed using the information collected from H010 claims submission.

Payment eligibility will be validated at the time of manual processing to ensure that payments are issued in accordance with the eligibility conditions described above.

• Please note that acceptance of an H010A claim by the payment system does not necessarily mean that payment eligibility has been met
• Individual claims of H010A will be paid at $0 on the remittance advice

The ministry anticipates issuing stipend payments to physicians on their individual (solo) remittance advice on a quarterly basis commencing in the fall of 2026.

The first payment will pertain to stipend services rendered from April 1, 2026, to June 30, 2026, based on claims available for manual processing as of August 27, 2026.

Claims submitted after August 27, 2026 will be processed for payment as part of the subsequent quarterly instalment. Accordingly, physicians may wish to prioritize the submission of stipend claims with service dates from April 1, 2026, to June 30, 2026.

Further information will be released at the time of the first payment.

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 .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 AM + 3.7 hours in the PM = 6.3 hours (payment Tier 6)
• Incorrect: 2.6 hours in the AM + 3.7 hours in the PM = 3 hours + 4 hours (payment Tier 7)

Keywords/Tags

Physician Services Agreement; PSA; Targeted Investment; Anaesthesia; Stipend; H010;

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.