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Contact us. To learn more about OMA Insurance programs call. 1-800-268-7215. (Monday – Friday 8:45am – 5pm ET) Or speak to an advisor.
- Health Care Spending Account for OMA Members - Manulife
OMA members who participate in OPIP and may have health...
- Health Care Spending Account for OMA Members - Manulife
To learn more about OMA Insurance programs call. 1-800-268-7215. (Monday – Friday 8:45am – 5pm ET) Or speak to an advisor. Benefit. Health. Health Plus. Co-insurance. Per insured person: 50% of the first $350 of eligible expenses, 90% thereafter.
Physicians must bill for insured services at the rates set out in the OHIP Schedule of Benefits. They may not bill any amount in excess of these rates. Physicians may select the rate they bill for uninsured services, unless they are otherwise prohibited from doing so. Read more below — or get the full details in the Physicians’ guide to ...
Toll-free: 1-866-532-3161 (toll-free) TTY: 1-800-387-5559 (TTY) 416-314-5518 (in Toronto) TTY: 416-327-4282 (in Toronto) Updated: August 30, 2024. Published: January 25, 2024. Get the latest Schedules of Benefits for OHIP covered services.This page is intended for health care providers. Learn more about services covered by OHIP.
- Background
- K083 Premiums
- K082 Focused Practice Psychotherapy Premium
- Family Health Group (FHG) Physicians - 10% Premium
- Management Fees For Services by Telephone Or Video
- Point of Care Drug Testing During Covid-19
- After Hours Procedure Premiums During Covid-19
- This Bulletin Is A General Summary
- The Schedule of Benefits For Physician Services
- Keywords/Tags
To ensure patients continue to access the heath care they need through the pandemic and the roll-out of the COVID-19 vaccine in Ontario, Schedule of Benefit for Physician Services (Schedule) amendments have been approved. These changes reflect an agreement between the Ministry of Health (ministry) and the Ontario Medical Association (OMA) to extend...
Effective March 14, 2021 the Schedule is being amended to permit payment of the temporary K083 Premiums listed in the K083 Premiums Table below, to specialists when providing K083 services, until September 30, 2021.
Effective March 14, 2021 the Schedule is being amended to temporarily permit payment of the focused practice psychotherapy premium with K082 psychotherapy services for eligible physicians. K082 for psychotherapy will be included as a service for which the amount payable to an eligible physician shall be automatically increased by 17% for the focuse...
Effective March 14, 2021 payment of the temporary FHG 10% premium with virtual care K-code services (K080, K081, and K082) is being extended until September 30, 2021. This FHG premium will be paid automatically to FHGphysicians rendering these virtual care K-code services to enrolled/assigned patients.
Effective March 14, 2021 the Schedule is being amended to temporarily permit K080, K081, K082 and K083 to be included as a consultation or assessment for the purposes of meeting the requirements for payment of the applicable management fee(s) listed in the Management Fees for Services by Telephone or Video Table below, until September 30, 2021.
Effective retroactive to March 14, 2020 and until March 13, 2021 the ministry and the OMA have agreed that payments equivalent to Schedule payments will temporarily be made for four point of care drug testing services (described in the Schedule by G040, G041, G042 and G043) when consultations and assessments using virtual care K-code services (K080...
As per INFOBulletin 201110, the ministry and OMA previously agreed to revised payment criteria for physicians to receive a premium when performing after hours surgical or other procedures as listed in General Preamble in the Schedule, effective November 28, 2020 until March 31, 2021. The ministry and OMA have now agreed to continue this until Novem...
This bulletin is a general summary provided for information purposes only. Physicians are directed to review the Health Insurance Act, Regulation 552, and the schedules under that regulation, for the complete text of the provisions. In the event of a conflict or inconsistency between this bulletin and the applicable legislation and/or regulations, ...
You can access current legislation and regulation at ontario.ca/laws. The latest version of the Schedule of Benefits for Physician Services is available on the Ministry of Health website. Hard copies of the Schedule of Benefits for Physician Services will not be distributed. If you would like to order a paper copy or compact disk (CD) of the Schedu...
COVID-19; Premiums; Management Fees; K083; K082; Focused Practice Psychotherapy Premium; FHGPremium; W010; Point of Care Drug Testing; G040; G041; G042; G043; After Hours Procedure Premium; E409; E410
Tax-free lump sum payment 2 of $50,000 after 30 days of surviving a diagnosis of one of 25 covered serious illnesses. Members under age 65 can also purchase an additional $50,000 each for coverage for themselves and their spouse. Learn more.
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OMA members who participate in OPIP and may have health coverage through their employer’s plan or their spouse’s plan can opt out of the OPIP Health plan and participate in the Health Care Spending Account (HCSA). Members who are under age 65 and have opted out of health coverage are allotted $350 for their HCSA and $50,000 for critical ...
