The OHIP Schedule of Benefits
Under the fee-for-service model, Ontario physicians must submit ‘invoices’ of who they saw and what they did through the medical claims electronic data transfer (MC EDT) system. To be reimbursed through OHIP for any healthcare services provided, a claim has to be submitted with the appropriate “Fee Schedule Code” along with the patient’s information.
Each fee code corresponds to a specific dollar amount. For example, if you’re a GP and you see a patient for a visit you can submit a claim with the fee code A005 (Consultation). This fee code has a value of $77.20, which is how much OHIP would reimburse you for.
Sadly, the Ministry of Health’s schedule of benefits is about 750 pages long and lists over 6,000 services – which makes finding the right code extremely tedious!
To make things easier for you, we’ve created a searchable database of OHIP fee codes so you can quickly find the OHIP fees for your specialty.
To get started,
search by speciality, code or keyword:
Or choose your specialty:
Anaesthesia
Cardiac surgery
Cardiology
Clinical immunology
Community medicine
Dermatology
Diagnostic radiology
Emergency medicine
Endocrinology & metabolism
Family practice & practice in general
Gastroenterology
General surgery
General thoracic surgery
Genetics
Geriatrics
Haematology
Infectious disease
Internal and occupational medicine
Laboratory medicine
Medical oncology
Nephrology
Neurology
Neurosurgery
Nuclear medicine
Obstetrics and gynaecology
Ophthalmology
Orthopaedic surgery
Otolaryngology
Paediatrics
Physical medicine & rehabilitation
Plastic surgery
Psychiatry
Radiation oncology
Respiratory disease
Rheumatology
Urology
Vascular surgery
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Other OHIP Billing Resources
Cut-off dates for MC EDT claim submissions for 2017/2018.
A searchable list of error codes along with descriptions.
Want to maximize your earnings? New to Ontario Billing?
Check out our Ultimate OHIP Billing Guide that takes you through every step for billing successfully in Ontario.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
