ontario regulation 58/26

made under the

Health Insurance Act

Made: March 26, 2026
Filed: March 27, 2026
Published on e-Laws: March 27, 2026
Published in The Ontario Gazette: April 11, 2026

Amending Reg. 552 of R.R.O. 1990

(GENERAL)

1. The definition of “schedule of benefits” in subsection 1 (1) of Regulation 552 of the Revised Regulations of Ontario, 1990 is amended by adding the following paragraph:

50.  Amendments dated March 9, 2026 (effective as of April 1, 2026).

2. Subsections 37.1 (2.0.1) to (2.8) and (2.11) of the Regulation are revoked.

3. Sections 37.1.1, 37.3 and 37.5 to 37.8.3 of the Regulation are revoked.

4. The Regulation is amended by adding the following sections:

37.8.3.1 (1) Subject to subsection (2), the basic fee payable for an insured service rendered by a physician in Ontario, as set out in the schedule of benefits, shall be increased by 2.8 per cent if the service is rendered on or after April 1, 2025 and before April 1, 2026.

(2) Subsection (1) does not apply to an insured service for which H fees are payable.

(3) In this section,

“H fees” has the same meaning as in the schedule of benefits.

. . . . .

37.9 The basic fee payable for an insured service rendered on or after April 1, 2026 and before April 1, 2027 by a physician in Ontario, as set out in the schedule of benefits, shall be increased by the percentage determined in the document entitled “Method for the Implementation of 2026/27 FFS Compensation Increases in The Ministry of Health (Ministry) and Ontario Medical Association (OMA) 2024 Physician Services Agreement”, dated February 25, 2026, published by the Ministry of Health and available on a website of the Government of Ontario.

5. The Regulation is amended by adding the following section:

37.12 Effective April 1, 2025, a premium is payable by the Plan to every physician in Ontario who rendered one or more eligible insured services in an eligible emergency department of a hospital, as calculated in accordance with the document entitled “Emergency Department Visit Premium for Workload and Fee for Service Sites”, dated February 27, 2026, published by the Ministry of Health and available on a website of the Government of Ontario.

6. (1) Paragraph 9 of subsection 38.4 (1) of the Regulation is amended by striking out “referring physician” at the end and substituting “referring physician, registered nurse in the extended class or dental surgeon”.

(2) Paragraph 5 of subsection 38.4 (2) of the Regulation is amended by striking out “referring physician” at the end and substituting “referring physician, registered nurse in the extended class or oral and maxillofacial surgeon”.

(3) Paragraph 6 of subsection 38.4 (2) of the Regulation is amended by striking out “referring physician or registered nurse in the extended class” at the end and substituting “referring physician, midwife, aboriginal midwife, registered nurse in the extended class or oral and maxillofacial surgeon”.

(4) Paragraph 7 of subsection 38.4 (2) of the Regulation is amended by striking out “referring physician” at the end and substituting “referring physician, registered nurse in the extended class or dental surgeon”.

7. Schedule 16 to the Regulation is revoked.

Commencement

8. (1) Except as otherwise provided in this section, this Regulation comes into force on the day it is filed.

(2) Section 5 is deemed to have come into force on April 1, 2025.

(3) Sections 1 and 4 come into force on April 1, 2026.