Bulletin 260803 — 2024 PSA – Emergency Medicine updates
This bulletin contains updates to emergency medicine related fee schedule codes.
To: All Emergency Medicine Physicians
Category: Physician Services
Written by: Claims Services Branch
Date issued: August 7, 2026
Bulletin Number: 260803
Overview
The Ministry of Health and the Ontario Medical Association have been working together to implement the 2024 Physician Services Agreement (PSA). As part of this work, 9 fee schedule codes (FSCs) related to emergency department after-hours services have been revised, and 2 new FSCs have been introduced.
| Fee Schedule Code | Description of change |
|---|---|
| H113A | Now billable on Friday evenings, and on Saturdays, Sundays or Holidays during daytime and evenings |
| H114A | New fee code for emergency department after hours service during evenings on Mondays – Thursdays |
| H131A, H132A, H133A, H134A | Now billable on Monday to Thursday evenings |
| H151A, H152A, H153A, H154A | Now billable Friday evenings, and on Saturday, Sunday or Holidays during daytime and evenings |
| H264A | New Emergency department pelvic exam with speculum fee code. |
After Hours Emergency Department FSCs
Effective April 1, 2026, the eligible periods of service for several emergency department after-hours FSCs were realigned.
As part of the phased implementation of the PSA, claims processing rules have now been updated to ensure these FSCs are paid in accordance with the revised eligibility criteria.
H113A: daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays and Friday Evenings (17:00h to 24:00h)
Effective April 1, 2026, the description of H113A was revised to include Friday evenings (17:00–24:00).
Beginning August 1, 2026, claims for H113A with a Friday date of service on or after April 1, 2026, will be paid at the applicable Friday evening, Saturday, Sunday, and holiday rate. Prior to this change, H113A would pay $0 with explanatory code V4 – Date of service was not a Saturday, Sunday or a statutory holiday when billed on a Friday date of service. Eligible claims will be adjusted to pay under the updated rules at a future date.
Claims with a service date that is not a Friday, Saturday, Sunday or Holiday will be paid $0 with explanatory code ‘VT - Date Of Service Is Not A Friday, Saturday, Sunday Or Statutory Holiday’.
H114A: evenings (17:00h to 24:00h) on Mondays to Thursdays
A new FSC, H114A, was introduced effective April 1, 2026, for emergency department after-hours services provided on Monday–Thursday evenings (17:00–24:00).
Effective August 1, 2026, rules have been updated to reject H114A with error code ‘ADJ – These Items May Not Be Claimed Together’ when billed with diagnostic ultrasound services other than J149B/C.
H131A to H134A: Monday to Thursday - Evenings (17:00h to 24:00h)
Effective April 1, 2026, the descriptions of H131A, H132A, H133A, and H134A were revised to remove Friday evenings from the eligible billing periods.
These FSCs are now limited to services provided on Monday–Thursday evenings (17:00–24:00).
H151A to H154A: Friday Evenings (17:00h to 24:00h) and Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h)
Effective April 1, 2026, the descriptions of H151A, H152A, H153A, and H154A were revised to include Friday evenings (17:00–24:00).
Beginning August 1, 2026, claims for these FSC with a Friday date of service on or after April 1, 2026, will be paid at the applicable Friday evening, Saturday, Sunday, and holiday rate.
Claims with a date of service that is not a Friday, Saturday, Sunday or Holiday will continue to be converted to their Monday – Friday daytime equivalent fee code (H101A – H104A). Prior to this change, H151A – H154A would convert to the Monday – Friday daytime equivalent fee code when billed with a Friday date of service. Eligible claims will be adjusted to pay under the updated rules at a future date.
Medical Claims Adjustment
A medical claims adjustment (MADJ) will be run for all the above fee codes at a future date to ensure any claims submitted between April 1, 2026, and August 1, 2026, are paid in accordance with the revised payment eligibility conditions. Details about the MADJ will be provided in a future INFOBulletin.
Keywords/Tags
Physician Services Agreement; PSA; physicians; ER; Emergency Department; H151A; H152A; H153A; H154A; H113A; H264A; H114A; H131A; H132A; H133A; H134A
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.