Ontario Health Insurance Plan

INFOBulletin

Aboriginal Midwife Requested Assessments

New: Aboriginal Midwife requested assessments effective July 1, 2022


To: All Physicians
Category: Physician Services
Written by: Provider Services Branch; OHIP, Pharmaceuticals and Devices Division
Date issued: June 15, 2022
Bulletin Number: 220604


Background

The Ministry of Health (ministry) is making changes to the Physician Schedule of Benefits (Schedule) to help improve equitable access to care for clients of Aboriginal Midwives. Changes will permit Aboriginal Midwives to make direct referrals to physicians, including specialists, and to directly order prenatal ultrasounds.

The term “Aboriginal Midwife” refers to midwives practicing under the exemption in the Regulated Health Professions Act (1991), whereby they are not required to be members of the College of Midwives of Ontario (CMO). This exemption recognizes and supports the autonomy of Indigenous midwives to provide traditional midwifery services to Indigenous persons or members of an Indigenous community.

As of July 1, 2022, the direct referral process for clients to physicians, including specialists will be consistent for all practicing midwives in Ontario. Physicians will be eligible for payment by the Ontario Health Insurance Plan (OHIP) for an assessment requested by a midwife registered with the College of Midwives of Ontario (registered midwife) or an Aboriginal Midwife. These changes will promote continuity of care within a culturally appropriate context for clients.

Claims Payment for Physicians

Effective July 1, 2022, physicians can claim existing fee codes in the Schedule when providing Aboriginal Midwife requested assessments.
The following list of fee codes have been updated to allow payment when an assessment is requested by either a registered midwife or an Aboriginal Midwife.

Fee Code

Description

A/C816

Midwife or Aboriginal Midwife-Requested Anaesthesia Assessment (MAMRAA)

A/C813

Midwife or Aboriginal Midwife-Requested Assessment (MAMRA)

A/C815

Midwife or Aboriginal Midwife-Requested Special Assessment (MAMRSA)

A/C800

Midwife or Aboriginal Midwife-requested genetic assessment

A/C801

Comprehensive midwife or Aboriginal Midwife-requested genetic assessment

A/C802

Extended midwife or Aboriginal Midwife-requested genetic assessment

K224

Clinical interpretation requested by a midwife or Aboriginal Midwife

Additionally, ultrasound for normal, complicated or high-risk pregnancy (but not for the postpartum period) rendered in an Independent Health Facility or hospital is insured when referred by a registered midwife or Aboriginal Midwife.

Use of Aboriginal Midwife Referral Number in Submitting Claims

The Aboriginal Midwives' six-digit OHIP identification number is required when submitting claims for Aboriginal Midwife requested assessment and Aboriginal Midwife referred ultrasound. For information on obtaining an Aboriginal Midwife OHIP identification number, please contact midwifery@ontario.ca.

Keywords/Tags

Aboriginal Midwife; Aboriginal Midwife Requested Assessments; Aboriginal Midwife Referred Ultrasound

Contact Information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.

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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