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Claims submitted with a modality indicator which contain services that are eligible to be provided virtually as well as services not eligible for payment when rendered virtually (those not listed in Appendix J of the Schedule) all on the same service date will have the non-virtual care eligible services approved at $0.00 with new explanatory code ‘B8 - Service Not Eligible for Payment ...
Dec 1, 2022 · If the referring physician agrees that ongoing specialist virtual care is medically necessary due to the complexity, seriousness or obscurity of the case and all other payment rules associated with consultations are met, a new consultation is eligible for payment and the subsequent 24-months of virtual assessments are payable as Comprehensive Virtual Care Services.
Dec 1, 2022 · Virtual Care Services are not eligible for payment (defined in General Preamble) where it is not medically appropriate to provide the specific service without a direct physical encounter. If, during the course of a Virtual Care Service, it becomes apparent that the service cannot be appropriately completed without a direct physical encounter ...
1. Existing Schedule Requirements –will apply to all virtual care services. 2. Appropriateness –virtual care services are not eligible for payment where it is not medically appropriate to provide the services without a direct physical encounter. 3. Video Services –must be performed using a Verified Virtual Visit Solution. 4.
- OHIP Virtual Care Billing Codes. On March 14, 2020 the MOH and OMA created four temporary OHIP billing codes in the schedule of benefits to facilitate telemedicine and virtual care.
- COVID-19 Diagnostic Code. A new diagnostic code, 080 with the description Coronavirus has been created to be used when the primary purpose for the service is treating patients with a suspected or confirmed case of COVID-19 whether in patient, by telephone, or video.
- COVID-19 Vaccine Fee Codes. On March 6, 2021, the MOH announced new fee codes to support the vaccine roll out. There are three specific codes that you can bill for administering the COVID-19 vaccine.
- COVID-19 Sessional Fee Codes. Two new sessional OHIP fee codes have been announced for physicians supporting vaccination services at hospitals or public health units (PHU) coordinated by COVID-19 Assessment Centres.
Dec 1, 2022 · As part of the 2021-2024 Physician Services Agreement, the Ministry of Health (MOH) and the Ontario Medical Association (OMA) agreed to a new virtual care funding framework that adds certain services provided by video and telephone as insured services under OHIP. This new framework replaces the temporary virtual care codes introduced in March 2020.
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Are virtual care services eligible for payment?
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Jul 7, 2021 · Enhance access to care - Better integration of virtual care services and tools within the health system could enhance patient access to care at home and in the community as part of publicly funded health services. It could also serve as a tool to improve equitable access for Indigenous, vulnerable and remote/rural populations, so long as barriers related to digital literacy and affordable ...
