News and announcements

New EPC billing briefs for time-based services 

The Education and Prevention Committee has developed two new briefs to help physicians and billing staff meet OHIP documentation and claims submission requirements for time-based services:  

• Requirements for time-based services
• Time-based services: Case-based billing examples

These new publications aim to reduce submission errors and are part of a joint OMA-Ministry of Health effort to ease administrative burden and increase billing accuracy. They provide guidance on how to use time-based fee codes, address common questions and include practical examples to support accurate billing. 

Please contact us at info@oma.org if you have any questions.  

Planning a leave from your practice? 

Whether the absence is for a sabbatical, health reasons or parental leave, our new temporary leave guidance offers clear, practical steps to help you manage it with confidence. This resource supports you every step of the way, from patient notifications to administrative tasks. 

Access updated LTC health assessment form

The Ministry of Long-Term Care has launched a modernized Health Assessment Form, which is used to complete the health assessment required by law when a person applies for long-term care.  

Through consultation and collaboration with users and key partners, including the OMA, the form has been updated to clarify some questions, make it easier to complete, and better address the information needs of all partners.  

You can find the new health assessment form, along with a guide and FAQ document, on the Ontario government’s Central Forms Repository.  

Supporting you in addressing requests from dentists

Members of the Section of General and Family Practice brought to our attention concerns related to requests received from dentists. After hearing your feedback, we’ve worked with the College of Physicians and Surgeons of Ontario and the Royal College of Dental Surgeons of Ontario to clarify expectations around these requests. 

We’ve developed a web page that outlines the expectations of physicians and dentists. It includes a template letter, accessible from your EMR, that you can use for responses. 

Measles: IPAC updates and reminders 

Public Health Ontario now recommends airborne, droplet and contact precautions for suspected or confirmed measles cases. This includes gown, gloves, eye protection, and a fit-tested, seal-checked N95 respirator. 

Community-based physicians practising in outbreak regions can contact Ministry of Health Infection Prevention and Control (IPAC) hubs with questions related to measles infection prevention and control at IPACHubs@ontario.ca. 

To avoid disruptions in your community-based practice, consider proactively asking staff to have documentation of their measles immunity status readily available. Staff without documented immunity will be required to isolate in the event of an exposure. 

Physicians of any specialty can use billing code K034 for reporting measles by telephone to a medical officer of health. 

For a summary of measles information, visit our measles web page. 

Measles resource now online

With the recent increase in measles cases in Ontario, visit our new measles web page for an overview of key recommendations on vaccination, screening, PPE, and more. The Office of the Chief Medical Officer of Health has advised that health-care workers who have already received two doses of a measles-containing vaccine or who have previously had measles do not need a booster.

We are also actively reviewing advocacy opportunities to enhance public health unit funding to respond to current measles outbreaks. This ensures that we are not only informing and supporting physicians with timely updates but also advocating for the public-health infrastructure necessary to reduce the burden on front-line care.

Updated RA and claims reconciliation guide now available

The updated claims reconciliation and remittance advice inquiry processes guide offers a review of OHIP fee-for-service for claim submissions for visits after April 1, 2023.

In the guide, you’ll find: 

• How to correct claims from an Error Report and a Reconciliation Advice report
• An introduction to eSubmit and how it can assist you in submitting documents

New tools to identify patients for cervical cancer screening. To help you identify patients that are eligible for cervical cancer screening, OntarioMD has developed HPV tools for TELUS PSS users.

You can find and download the four searches and two reminders on the OMD Educates website. You can also find links to new HPV requisition forms for the most commonly used EMRs. If you need assistance, please contact your EMR vendor or OMD directly.

CPSO begins regulating physician assistants

As of April 1, physician assistants are required to register with the College of Physicians and Surgeons of Ontario to continue practising under the physician assistant title in this province. 

While the new requirement brings PAs under formal regulation, their working relationship with physicians remains the same. They can still only perform controlled acts through delegation and with appropriate supervision by a physician, as set out in the CPSO’s Delegation of Controlled Acts policy.  

A physician assistant’s scope of practice will reflect their supervising physician’s scope and is based on the PA’s knowledge, skill and judgment. 

Visit the CPSO’s website to learn more.

Updates on interprovincial billing rates, preventive care and more

The Ministry of Health provided updates on a number of key issues this week, including the following:

• The new interprovincial billing rates for the 2025-26 fiscal year for outpatient and inpatient services, well newborns, high-cost transplants and special implants and devices are effective as of April 1, 2025
• The MOH has updated the cumulative preventive care bonus cervical cancer screening. This involves changes to the preventive care pap smear category
• Physicians are requested to claim for the preventive care service levels they have achieved for their enrolled patients during the period April 1, 2024, to March 31, 2025
• Applications for the Northern Physician Retention Initiative are now available on Ontario.ca. The deadline to apply is April 30, 2025

Have your say on CPSO policy updates

The College of Physicians and Surgeons of Ontario is updating and seeking consultation on two policies, and we invite your feedback. 

1. Delegation of Controlled Acts policy: This policy sets out expectations for physicians about when and how they can delegate those controlled acts 
2. Boundary Violations policy: This policy sets out expectations for physicians regarding sexual and non-sexual boundaries, intimate examinations, sexual relationships with former patients and people close to patients, and mandatory reporting duties

Lend your voice on physician health and well-being

Our Physician Health Program encourages you to participate in the Canadian Medical Association’s 2025 National Physician Health Survey.

This confidential survey measures key wellness indicators such as burnout, anxiety, depression and the impacts of administrative burden, safety and health sector leadership on physicians.

The data collected will help identify challenges, shape solutions, inform advocacy efforts, and advance health and wellness programs like the PHP to support medical learners and physicians like you across their careers. 

All Canadian medical students, residents and practising physicians can participate until April 15. Send your questions and feedback to yourvoice@cma.ca. 
Simplify OHIP billing with our collection of billing guides

We’re committed to providing the knowledge and tools to help you quickly and accurately bill OHIP and get compensated for your work.

A new guide on addiction medicine services fee codes was published last week, adding to our collection of 18 billing guides covering a range of topics from after-hours premiums to palliative care.

Have suggestions for new guides or feedback on the ones we’ve published? We’d love to hear from you!

Your OPIP Statement of Annual Premium is now available 

Your OMA Priority Insurance Program Statement of Annual Premium is now available on Manulife SecureServe. If you need assistance or have questions, contact Manulife’s dedicated line for OMA members at 1-888-596-8881 (8 a.m. – 8 p.m. EST Monday to Friday). Please have your OMA number on hand.

Supporting Indigenous physicians

The Physician Health Program has partnered with the Indigenous Physicians Association of Canada to create a collaborative video highlighting their shared commitment to supporting Indigenous physicians, medical students and residents. The PHP is dedicated to making its services more culturally safe and accessible for Indigenous physicians. We encourage you to explore the Canadian Medical Association’s Indigenous wellness and healing resources. 

Updated fee code master now available

The Ministry of Health has posted a new fee code master that continues to reflect an across the board increase of just over 13 per cent from Year 1 of the 2024-28 PSA and Year 3 of the 2021-24 PSA. This temporary increase applies to services provided between Jan. 1 and March 31, 2025. 

The only changes in this updated version are two new laboratory medicine services tracking codes: L699 and L734. 

You can download the new master now to use with your billing software. If your vendor hasn’t updated your software or you have technical questions about your billing package, please contact your vendor.