On August 23, 2022, OHIP released an INFOBulletin containing important updates regarding the temporary increases for Physician Services Payments of 2.01% for the period April 1, 2022 to March 31, 2023.
Claims will be adjusted for technical services performed in hospital
When OHIP’s temporary 2.01% increase was originally announced, hospital technical fees were not eligible. However, OHIP noted that these codes have been receiving the increased value until a system change could be implemented.
This system change has now occurred and effective August 1, 2022, technical fees in-hospital with a service date on or after April 1, 2022, will be paid at the Schedule of Benefits for Physician Services rates.
A Medical Claims Adjustment (MADJ) will be required to reprocess claims for technical services performed in hospital that were assessed between April 1, 2022, and July 31, 2022.
Fee Schedule Codes being adjusted to the correct rate will appear on the Remittance Advice with explanatory code ‘80-Technical Fee Adjustment for Hospitals’. At this time, it doesn’t appear that any action is required on the part of physicians. However, the OHIP INFOBulletin stipulated that further information will follow in advance of the adjustment.
View the original OHIP INFOBulletin for more information on the hospital technical services impacted.
Reciprocal Medical Billing services are now eligible for the increase
The August 23 INFOBulletin also provided a correction to a previously published bulletin. According to this correction, payments made through the Reciprocal Medical Billing (RMB) payment program are now eligible for the temporary 2.01% increase with the exception of technical services performed in hospital.
Questions about this OHIP update?
View the original August 23 INFOBulletin for further details. OHIP also noted that questions can be directed to SSContactCentre.MOH@ontario.ca or 1-800-262-6524.