July 2025 RMA and OHIP News
- 4 min read
Every month, RMA compiles and summarizes the most important OHIP billing updates and RMA news for your convenience. July’s news is summarized below.
Relativity Payments
INFOBulletin #20250601 reported that some eligible relativity payments were not paid as reported on the Relativity Summary Report in the June Remittance Advice (RA). In those cases, the reported amount did not match the amount received. Therefore, the ministry recommended holding off distribution of funds until they resolved this issue. INFOBulletin #250701 announces that the issue has been resolved and that the relativity payments have been corrected on the July Remittance Advice. Relativity payments will appear on your July Statement of Earnings as a separate line item. For July, this will be a total payment from the June and July RAs. Going forward, the payment will be applied each month.
2024 Physician Services Agreement Year 1 Increases
INFOBulletin #250605 announced the 9.95% across-the-board compensation increase on physician payments for the remaining period of November 1, 2024 to December 31, 2024 as part of Year 1 of the 2024 Physician Services Agreement (PSA). The 9.95% across-the-board compensation increase for the period of April 1, 2024 to October 31, 2024 was previously announced in INFOBulletin #250501.
Payment is being made directly to the physician’s solo account. However, members enrolled in an Academic Health Sciences Centre (AHSC) alternative funding plan (AFP) will be paid 40% of the eligible retroactive amount from the ministry via their solo account on or about July 15, 2025. Per the terms of your AHSC contract, the remaining 60% will flow through your AHSC physician association (HAHSO). The 60% of funding will lag slightly behind the 40% as it goes through the conversion process; therefore, please contact your associated department for payment timelines.
Physicians will receive a compensation increase report from the ministry delivered to their solo account with the details of their compensation payment. To access your solo account, log on to OPS (Ontario Public Service) BPS (Broader Public Service) secure account by visiting https://www.edt.health.gov.on.ca, if you don’t know your OPS BPS Secure credentials, you can email ProviderRegistration.Moh@ontario.ca.
2024-25 Community Access Pilot
INFOBulletin #250603 announced that the community access pilot for laboratory services will be extended to March 31, 2026.
Education and Prevention Committee (EPC) Billing Brief for Time-Based Services
The MOH released the following two EPC billing briefs to advice physicians what the requirements are for time-based services and how to bill them. The EPC briefs can be found by clicking the links below.
Examples of key requirements and common claims issues for time-based services are as follows:
- The start and stop times of the time-based service must be recorded in the patient’s medical record. Indicating the time instead of the start and stop time is not acceptable. (Example, “I spent 20 minutes with this patient”, instead of wording that meets payment requirements, “Patient assessed from 10:05 am to 10:25 am”).
- The physician must spend the minimum amount of time specified in the Schedule for the time-based service. (Example, if the minimum time required is 46 minutes to claim two units of the service, but the documented start and stop time is equal to 45 minutes, the minimum time has not been met in order to claim 2 units and only one unit is payable.)
- Services must be personally rendered by the physician (unless rendered by postgraduate medical trainee). A nurse or an employee of the physician or hospital is not a medical trainee.
- The time claimed for time-based services must not overlap with time spent providing any other billable service (to the same or any other patient).
Certain time-based services require a pre-booked appointment. If the time-based service was not pre-booked, the service is not eligible.
For more information...
RMA has over 40 years of experience and expertise in the medical billing field. Our staff is always happy to help update physicians on the latest billing news. If you want more specific information on each INFOBulletin, check out the official website.
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