Overview

The information contained in the OHIP Schedule of Benefits requires knowledgeable interpretation and is intended primarily for members of the professional health care community. The Schedules set out the fees and requirements for payment for insured services under OHIP.

The OHIP Schedule of Benefits is not available in French or in alternative formats.

Schedule of Benefits for Physician Services

Physician Services Under the Health Insurance Act (PDF) - June 29, 2023 (effective July 24, 2023)

OHIP Physician Fee Schedule Master

These files are intended for use with billing software.

The Physician Fee Schedule Master below is effective September 1, 2023.

If your billing software has not been updated by your vendor, you are encouraged to do so at your earliest convenience.

Please direct technical inquiries to your billing package developer orvendor.

Schedule of Benefits for Optometry Services

Optometry Services Under the Health Insurance Act (PDF) - March 11, 2023 (effective September 1, 2023)

OHIP Optometry Fee Schedule Master

These files are intended for use with billing software.

The Optometry Fee Schedule Master below is effective September 1, 2023.

If your billing software has not been updated by your vendor, you are encouraged to do so at your earliest convenience.

Please direct technical inquiries to your billing package developer or vendor.

Schedule of Benefits for Dental Services

Dental Services Under the Health Insurance Act (PDF) - October 15, 2021 (effective November 5, 2021)

Schedule of Benefits for Laboratory Services

Laboratory Services Under the Health Insurance Act (PDF) - July 5, 2023 (effective July 24, 2023)

Schedule of Facility Costs for Integrated Community Health Services Centres

Schedule of Facility Costs for Community Surgical and Diagnostic Centres (PDF) - March 9, 2023 (effective September 25, 2023) 

Contact

For more information, call ServiceOntario, INFOline at: