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  1. Dec 1, 2022 · Initiating a Virtual Care Service. A Virtual Care Service is not eligible for payment unless the physician service is initiated by the patient or the patient’s representative, or the service represents a medically necessary follow-up visit to a preceding visit initiated by the patient or the patient’s representative.

  2. 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 ...

  3. Dec 1, 2022 · In this case, it was not possible to complete a Virtual Care Service and so no Virtual Care Service is eligible for payment. If Dr. Valderrama rendered a virtual assessment when it was not medically appropriate to do so, then the assessment would not be eligible for payment.

  4. 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.

  5. the virtual care technologies that best meet the needs of their patients and practices (e.g. technologies other than those currently offered by OTN). 2.2 Virtual Care Program To be eligible to submit claims, Ontario physicians and dentists 3 must submit a registration form 4 and register with the ministry for virtual care billing privileges.

  6. The described service is a Comprehensive Virtual Care Service as it is a Specialist Video Consultation and could be claimed as A025A (with the K300A modality indicator) provided that the Schedule specifications for consultations have been met. Source: Virtual Care 1: Comprehensive and Limited Virtual Care Services

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  8. Check for any applicable costs or fees associated with using the virtual care platform or service. Virtual care is covered in a lot of instances, but doctors can charge a reasonable fee for services that aren’t covered by OHIP. Doctors must tell you how much a service will cost before they provide it.

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