In this series, we’re going to cover common ‘Anesthesia Age Premiums’ for Ontario Physicians. This is mainly for physicians who are providing anaesthesia services, which allows them to claim additional units based on certain patient characteristics. These additional units are outlined in the Schedule of Benefits.
The following codes are now automated for payment purposes (as of June 1, 2008).
E014C - newborn to 28 days
E009C - 29 days to a year
E019C - 1 year to 8 years inclusive
E007C - adult 70 - 79 inclusive
E018C- adult 80 and older
For service dates on, or after June 1, 2008, it’s no longer necessary to submit these fee codes for payment, as the extra units will be calculated and paid automatically.
Any fee codes submitted with service dates on, or after June 1, 2008, will be paid at $0 with explanatory code 30 (This Service is Not a Benefit of OHIP).
Payment for all age premiums will appear as an accounting adjustment on the Remittance Advice (RA) with the description “Anaesthetic Age Premium”.
Note: E021C (premature newborn less than 37 weeks gestational age) has not been automated and should continue to be claimed as part of claims submission.
If you have any questions regarding Anesthesia Age Premiums’, please don’t hesitate to contact us here.