The OHIP Schedule of Benefits
Under the fee-for-service model, Ontario physicians must submit 'invoices' of who they saw and what they did through the medical claims electronic data transfer (MC EDT) system. To be reimbursed through OHIP for any healthcare services provided, a claim has to be submitted with the appropriate "Fee Schedule Code" along with the patient's information.
Each fee code corresponds to a specific dollar amount. For example, if you’re a GP and you see a patient for a visit you can submit a claim with the fee code A005 (Consultation). This fee code has a value of $77.20, which is how much OHIP would reimburse you for.
Sadly, the Ministry of Health's schedule of benefits is about 750 pages long and lists over 6,000 services – which makes finding the right code extremely tedious!
To make things easier for you, we've created a searchable database of OHIP fee codes so you can quickly find the OHIP fees for your specialty.