The MOH announced two new sessional OHIP fee codes for physicians supporting vaccination services at hospitals or public health units (PHU) coordinated by COVID-19 Assessment Centres. As we work with our physicians, we are finding the process can be confusing. To help physicians gain a better understanding of how to bill for their services provided in COVID-19 Assessment Centres, we have prepared some tips on fee codes H409 and H410.
H409 and H410 Sessional Fee OHIP Billing Codes
The H409 and H410 OHIP fee codes provide comprehensive payment for all insured services rendered during the applicable time period and for being present at the vaccination site to provide such services. No other fee codes are eligible for payment during the applicable time periods.
|Fee Code||Fee Code Description||Fee Code|
|H409||COVID-19 Sessional Unit-per one-hour period, or major Part thereof||$170|
|H410||COVID-19 Sessional Unit-per one-hour period, or major part thereof on Saturdays, Sundays, holidays or Monday to Friday afterhours (5pm-7am)||$220|
Some requirements for billing the H409 and H410 fee codes:
- These codes are eligible for payment for COVID-19 vaccination planning, administrative, or leadership services when requested by a hospital or PHU.
- They must be submitted with the group number assigned to the hospital or PHU that coordinated the vaccine service delivery.
- They are eligible for payment for all services rendered on or after December 14, 2020 at a hospital or public health unit coordinated COVID-19 vaccinate sites.
- They must be billed for every hour of service provided. For example, if you work supporting vaccination services on a Monday for 2 hours during office hours and 2 hours after 5pm, you will bill as follows:
- Fee code H409 x 2 = $340
- Fee code H410 x 2 = $440
How to Bill Codes H409 and H410 in your EMR
While each EMR has some unique characteristics, there are some general guidelines on how to submit your H409 and H410 codes:
- Create a new doctor billing profile.
- Add in your Group Number. This Group Number is obtained from the hospital or PHU vaccination lead or the COVID-19 Assessment Administrator of the coordinating entity.
- Once the new billing profile is created, add the code H409 and/or H410 to one encounter on a “fake” patient for the date of service you worked.
- This fake patient will be billed the same as your Preventive Screening Bonus or set as a Bonus Code in your EMR.
- Generate the submission as you normally would when submitting a claim and upload to the MOH. As a best practice, we recommend that you manually upload this file created by your EMR directly to MCEDT itself.
While the overall process to submit your H409 and H410 fee codes is the same for all EMRs, it may appear slightly different depending on your EMR interface. If you have any questions, please don’t hesitate to reach out to us! We’re happy to help.