Ontario Health Insurance Plan

INFOBulletin

Extending COVID-19 Sessional Fees at Assessment Centres

Temporary COVID-19 sessional fees H409 and H410 for physicians at eligible assessment centres are in effect until September 30, 2021


To: All Physicians
Category: Physician Services
Written by: Health Services Branch, Ontario Health Insurance Plan Division
Date issued: March 12, 2021
Bulletin Number: 210305


Background

In March 2020, the Ministry of Health (ministry) temporarily listed as insured services under the Ontario Health Insurance Plan (OHIP) COVID-19 sessional fees for physicians providing services at eligible assessment centres designated by the ministry. Please refer to INFOBulletins 4745 and 4747 for more details.

To further support Ontario’s vaccine rollout and the government’s efforts to stop the spread of COVID-19, the Schedule of Benefits for Physicians Services (Schedule) is being amended pursuant to an agreement reached by the ministry and the Ontario Medical Association (OMA) to further extend the temporary COVID-19 sessional fee codes H409 and H410 to September 30, 2021, as outlined below.

Eligible Assessment Centres and COVID-19 Sessional Fees

Effective March 14, 2021 the Schedule has been amended to extend the COVID-19 sessional units for insured services rendered by physicians at eligible assessment centres designated by the ministry until September 30, 2021. The COVID-19 sessional units will continue to be payable in accordance with two temporary fee codes:

COVID-19 sessional unit

H409-per one hour period, or major part thereof-$170.00
H410-per one hour period, or major part thereof on Saturdays, Sundays, holidays or Monday to Friday after hours (5pm -7am)-$220.00

Examples

Examples of scenarios that are eligible for payment under H409 and H410:

  • COVID-19 testing services rendered within COVID-19 Assessment Centres established in coordination with Ontario Health.
  • COVID-19-related Infection Prevention and Control (IPAC) services rendered within Long-Terms Care Homes (LTCHs) or Congregate Care Settings (CCS) requiring a hospital-coordinated IPAC response.
  • COVID-19-related testing services rendered within LTCHs or CCSs requiring an Assessment Centre coordinated response.
  • COVID-19-related IPAC services OR COVID-19-related testing services rendered within LTCHs, CCSs, or other institutional settings requiring an Ontario Health Region or a LHIN-coordinated response.
  • COVID-19-related clinical care services rendered within LTCHs or CCSs requiring hospital-coordinated clinical support.
  • COVID-19 vaccination services rendered within vaccination sites coordinated by a hospital or a public health unit (PHU), as well as COVID-19 vaccination planning, administrative, or leadership services when requested by a hospital or by a public health unit that is responsible for coordinating one or more COVID-19 vaccination sites. Please refer to INFOBulletin 210204 for more details on physician remuneration for COVID-19 vaccination services.

The amount payable for a COVID-19 sessional unit is for all insured services rendered during that hour and for being physically present in an eligible assessment centre and available to provide such insured services. No other insured services are eligible for payment at an eligible assessment centre.

This bulletin is a general summary

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. You can access current legislation and regulation at ontario.ca/laws. In the event of a conflict or inconsistency between this bulletin and the applicable legislation and/or regulations, the legislation and/or regulations prevail.

The Schedule of Benefits for Physician Services

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 Schedule for a fee, please visit Publications Ontario. Physicians without access to the Internet can contact ServiceOntario at 1-800-668-9938.

Keywords/Tags

COVID-19; Assessment Centres; H409; H410; Sessional Units;

Contact Information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.
Find INFOBulletins online on the Ministry of Health website.

For More Information

Call ServiceOntario, Infoline at:
1–866–532–3161 (Toll–free)
In Toronto, (416) 314–5518
TTY 1–800–387–5559.
In Toronto, TTY (416)327–4282
Hours of operation: Monday to Friday, 8:30am – 5:00pm

 
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