Ontario Health Insurance Plan

OHIP Schedule of Benefits and Fees

This information requires knowledgeable interpretation and is intended primarily for members of the professional health care community.

The OHIP Schedule of Benefits and Fees is not available in French.


Schedules Available

Physician Services – Schedule of Benefits

Physician Services Under the Health Insurance Act [PDF] - June 29, 2023 (effective July 24, 2023)


OHIP Fee Schedule Master – (For use with Billing Software)

The Fee Schedule Master below is effective September 1, 2023. If your Medical Billing Software has not been updated by your vendor, you are encouraged to do so at your earliest convenience.

Please direct technical inquiries to your Billing Package Developer / Vendor.

Resources


Community Surgical and Diagnostic Centres

Centres licenced under the Integrated Community Health Services Centres Act, 2023 (formerly known as Independent Health Facilities) are able to bill facility costs under the schedule below.


Services of Optometrists


OHIP Optometry Fee Schedule Master – (For use with Billing Software)

The Optometry Fee Schedule Master below has been updated effective September 1, 2023.

If your Medical Billing Software has not been updated by your vendor, you are encouraged to do so at your earliest convenience.

Please direct technical inquiries to your Billing Package Developer / Vendor.

Resources


Laboratory Services

Schedule of Benefits for Laboratory Services


Dental Services

Schedule of Benefits [PDF] – Effective October 1, 2021


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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, 8:30 a.m. – 5:00 p.m.

 
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