The Ontario Ministry of Health and OMA have agreed to temporary OHIP billing codes in the schedule of benefits to facilitate telemedicine and virtual care. While these fee codes are not limited to COVID-19 screening or COVID-19 patients, they have been put into place in an effort to reduce the risk of disease spread by keeping people at home and out of doctors’ offices.
These codes are in effect as of Saturday, March 14, 2020.
The codes available to primary care are K080, K081, and K082. These codes are considered in-basket (i.e. for FHO/FHN physicians, they will be paid at the shadow billing rate for rostered patients, and full fee-for-service rate for non-rostered patients).
- You can bill the Q012 after-hours premium against K080, K081, and K082 when appropriate.
- Services must be documented on the patient’s medical record (including the start and stop times) or the service is not eligible for payments.
- These codes will not contribute to Outside Use.
- K080, K081, and K082 are insured when the service was initiated by the patient or the patient’s representative and the service is personally rendered by the physician.
- These fees will not contribute to the Fee-For-Service-Hard-Cap.
The MOH has advised they will need some time to set up the billing. While you can use these codes to start telephone and video services right away, we recommend holding off billing related to these codes for a few weeks. For additional details, you can read the most recent OHIP bulletins:
- OHIP Bulletin 4745 “Changes to the Schedule of Benefits for Physician Services (Schedule) in response to COVID-19 influenza pandemic”
- OHIP Bulletin 11229 “Primary Care Changes in response to Corona Virus (COVID-19)”
DoctorCare will continue to keep you informed as we receive updates from MOH on additional developments. In the meantime, if you have any questions at all, please reach out to us at email@example.com or call us at 1-844-853-6396. We are here to help.