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  1. At the time of service, both the patient and provider must be physically present in Ontario for insured in-province services to be eligible for payment. Virtual care services are not eligible to be submitted through Reciprocal Medical Billing (RMB).

  2. Dec 1, 2022 · Virtual Care Services are not eligible for payment unless personally performed by the physician or rendered in accordance with the payment rules regarding supervision of a Medical Trainee specified in the General Preamble.

  3. Dec 1, 2022 · Virtual Care Services provided to hospital inpatients or patients in a long-term care institution are not eligible for payment unless all of the following requirements are met: The physician providing the service is not the patient's Most Responsible Physician (MRP).

  4. Existing Schedule Requirements – will apply to all virtual care services. Appropriateness – virtual care services are not eligible for payment where it is not medically appropriate to provide the services without a direct physical encounter. Video Services – must be performed using a Verified Virtual Visit Solution.

    • 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.
  5. As of April 1, 2020, the only eligible Virtual Care Program codes are: • B103A: $0.00 Hosted Video Visit – patient attending at a patient host site o Fee code for a synchronous video visit with a patient who is physically

  6. Dec 12, 2022 · Virtual care services are not eligible for payment where it is not medically appropriate to provide the services without a direct physical encounter. Video visits must be performed using a Verified Virtual Visit Solution (Cortico is a verified provider).

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