
There are no changes to how you bill OHIP.
Bill the usual way, then use the RA to see whether OHIP paid the usual fee with the extra percentage for your bucket added on.
You do not change the way you bill. You still send OHIP the normal billing code for the visit or service. Then OHIP does the math for the increase and sends you the payment.
So the idea is:
1. Bill the service normally
Use the regular code from the Schedule.
2. Look at your RA later
The RA is like a report card that shows what OHIP paid you.
3. Check if the payment is a little bigger
If you are in the regular family doctor FFS group (00_2), the payment should usually be about 6.2901% more than the basic listed fee. The 2026/27 ministry memo says family medicine has different buckets, and 00_2 Family Medicine – FFS gets 6.2901%. It also says the basic fee is multiplied by the rate for your bucket.
What this means in practice:
For a typical FFS family doctor in 00_2, you can usually do this:
RA spot-check = listed fee × 1.062901
Example:
- A007 listed fee 44.55
- 44.55 × 1.062901 = 47.35
- So if the claim paid cleanly, 47.35 is the rough number you would expect on the remittance side.
So, in very plain words:
Check the bottom of this page for your Specialty's Relativity Rate. Attached you will also find a PDF copy of the PHYSICIAN SERVICES AGREEMENT.
Bill your normal fee + your bucket increase = about what you should get paid
- bill normally, service code fee example = $100
- your increase = 6.2901%
- expected payment on RA = about $106.29
But this is only the simple check.
Sometimes the number can be different because:
- the claim had a rule or limit
- the service was reduced
- it was a technical fee
- it was not eligible exactly as billed
- Some technical fees are treated differently, and hospital technical fees do not get this increase.
So the easiest way to remember it is:
Bill normally.
Then check the RA.
See if the amount paid is about the normal fee plus your specialty increase.
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