Notes:
*Please note that the numbers & C987 apply only to the "C" codes because C998 & C999 were already assigned to Surgical Assistants. For all other letters i.e. A, B, K, U & W the numbers remain 998 & 999
*If you are billing the WOIO monthly LTC code, the following services are included in the code & may not be billed as separate services: W003, W008, W121, W872, W102, W104, W107, W903, W109, W004, W777, W771, G271, K070, 1<071, K072, G489, G372, G373, G538, G539, G590, G365, G394, E430, G379, 6001, G002, G481, G003, G004, G005, G006, G007, G008, G009, GOIO, G012, G014.
*Maximum one per day, up to 16 per calendar year. Use G291/G292 when more than 16 per year. **G265 for each additional, up to 3, when G264 is payable in full.
*This is the most current fee guide and represents a base. With the recent year 1 arbitration award, from April 2025 to March 2026, a relativity-adjusted payment structure will be applied to all OHIP fees based on your payment model. These increases will be reflected in the payments you receive. Increases are the following: GP-I Capitation: 11.7513% GP-2 FFS: 12.7535% GP-3 Salary/Contracts: 13.5477%. These amounts will be in place until March 2026. Permanent adjustment to the schedule of benefits will take place in April 2026. These increases are currently being reviewed as part of the bi-lateral Physician Payment Committee (PPC) process.
*Physicians are advised to consult with the OHIP Schedule of Benefits for the specific details of each of these codes. The Schedule of Benefits describes mandatory service requirements and billing restrictions. https://health.gov.on.ca/en/pro/programs/ohip/sob/