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Bill OHIP for Services Requested by an Aboriginal Midwife

Tracy B.
Jun. 21, 2022
3-minute read

Effective July 1, 2022, clients of Aboriginal Midwives in Ontario will receive more equitable access to care. Aboriginal Midwives may now make direct referrals to physicians (including to specialists) and order prenatal ultrasounds. 

This announcement also means that physicians will be eligible for payment by OHIP for providing assessments requested by either an Aboriginal Midwife or a midwife registered with the College of Midwives of Ontario.

No new fee codes are required. Instead, the following fee codes have been updated:

Fee CodeDescription
A800 / C800Midwife or Aboriginal Midwife-requested genetic assessment
A801 / C801Comprehensive midwife or Aboriginal Midwife-requested genetic assessment
A802 / C802Extended midwife or Aboriginal Midwife-requested genetic assessment
A813 / C813Midwife or Aboriginal Midwife-Requested Assessment (MAMRA)
A815 / C815Midwife or Aboriginal Midwife-Requested Special Assessment (MAMRSA)
A816 / C816Midwife or Aboriginal Midwife-Requested Anaesthesia Assessment (MAMRAA)
K224Clinical interpretation requested by a midwife or Aboriginal Midwife

In addition to the above, ultrasounds for normal, complicated or high-risk pregnancy (excluding the postpartum period) rendered in an Independent Health Facility or hospital are insured when referred by a registered midwife or Aboriginal Midwife.

NOTE: The six-digit OHIP identification number for the referring Aboriginal Midwife is required when submitting claims. For information on obtaining an Aboriginal Midwife OHIP identification number, you can contact midwifery@ontario.ca.

Creating a Consistent Direct Referral Process for all Practicing midwives in Ontario:

“These changes will promote continuity of care within a culturally appropriate context for clients,” explains the recent Ministry bulletin announcing the update. “As of July 1, 2022, the direct referral process for clients to physicians, including specialists, will be consistent for all practicing midwives in Ontario.”

“The term Aboriginal Midwife refers to midwives practicing under the exemption in the Regulated Health Professions Act (1991), whereby they are not required to be members of the College of Midwives of Ontario (CMO). This exemption recognizes and supports the autonomy of Indigenous midwives to provide traditional midwifery services to Indigenous persons or members of an Indigenous community.”

Read the complete original INFOBulletin posted by the Ontario Ministry of Health. 

Questions About Billing Using the Updated Codes? 

Dr.Bill users can start billing using the updated codes (along with the six-digit OHIP identification number for the referring Aboriginal Midwife) as soon as the codes take effect on July 1, 2022. Questions? Contact us or direct message us right in the Dr.Bill app.

Search All OHIP Billing Codes

Search the Ontario Schedule of Medical Benefits electronically. We’ve digitized all the OHIP billing codes so you can easily find the most up to date billing rules and amounts.

OHIP Billing Codes
Tracy is a seasoned senior-level content writer and full time team member at Dr.Bill. By staying closely connected to the needs of Canadian healthcare professionals, she creates to-the-point content that helps physicians manage their medical billing and their practices better.
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This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.

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