What are the New Changes to the OHIP Schedule of Benefits, Effective April 1, 2012

There has been a lot of talk and speculation about the changes to the OHIP Schedule of Benefits, but what are they?  We’re going to give you a summary here, there are deletions, changes and additions.  Let’s start with the deletions.  We will not delete these codes from our database (www.ombis.ca) until our members have had a chance to reference these changes with the database.  The codes will remain in the system until the end of May.  

Deletions:

C101

E381

E806

G465

G693

J191

J192

J194

J195

J491

J492

J494

J495

As far as codes with fee decreases, there are far too many to list but please do follow this link to see each code specifically.  We’re willing to bet that every physician will be affected by these cuts, it’s definitely not as “targeted” as the media is making it out to be. 

Fee Decreases:

http://www.health.gov.on.ca/english/providers/program/ohip/bulletins/4000/bul4561_5.pdf

New Fee Codes

J710 – PET Scan – Esophageal Carcinoma ($250)

K738 – Physician to Physician e-Consultation, Referring Physician ($16.00)

K739 – Physician to Physician e-consultation, consult physician ($20.50)

There are also a significant amount of percentile based payments that have been decreased, again, wide-sweeping and far too many to list.  No matter what your area of practice, follow the link below to see the affected changes.

Percent Decreases:

http://www.health.gov.on.ca/english/providers/program/ohip/bulletins/4000/bul4561_4.pdf

Our members will notice the changes within our database (with the exception of the fee code deletions, as noted above) within the next few days. 

A significant fact to keep in mind is that these changes have already come into effect and, in fact, are retroactive to April 1, 2012, which means the changes will be felt immediately.