New OHIP billing codes paying ~$25 more than old codes
On May 1, 2017, The Ministry of Community and Social Services (MCSS) simplified the Ontario Disability Support Program (ODSP) Medical Review process with two new forms and new OHIP billing codes.
But since then, through our continued work with doctors across Ontario, we have discovered that most doctors are using the old set of OHIP billing codes when the new codes actually pay ~$25 more. We would like to remind and encourage doctors to use these new forms and codes.
Information on the new forms and OHIP billing codes
Medical Form Part A is mandatory – The form asks you about the patient’s previously identified medical conditions, impairments and restrictions.
Medical Form Part B is optional – You only complete it if there have been clinically significant improvements in a patient’s medical conditions, impairments and restrictions not listed in Part A. Part B contains the Health Status Report (HSR) section and Activities for Daily Living Index (ADLI) section.
New OHIP billing codes
Along with the new forms, there are new fee OHIP billing codes (K057 – K060) you can bill instead of the cumbersome and confusing K050-K056. If you are completing Part A of the form, you will be billing code K057. For Part B, it would depend on if you are doing the HSR or the ADLI, or both.
Looking for more details? Read the full Schedule of Benefit Update.
Have questions about filling out your MCSS ODSP forms? We can help!