A temporary fee code (G593) set at $13.00, will be established which will be payable for each administration of the initial COVID-19 vaccination series when delivered by a physician outside of a ministry designated COVID-19 Assessment Centre. In addition, a new Q593 code set at $5.60 will be introduced for Patient Enrolment Models (PEMs) other than CCM and FHG.
When the vaccine is administered as the sole service of the visit:
- CCM/FHG/FFS physicians would bill G593 and G700
- Physicians in all other PEM models would bill G593 and Q593 (value set at G700)
When billed with other insured services, all models can bill G593 and the applicable visit fee.
A summary of how to bill is provided in the table below.
|Sole Visit||CCM/FHG/FFS||Enrolled & Non-Enrolled||G593 + G700||$13.00+$5.60 = $18.60|
|Sole Visit||All Other PEM*||Enrolled & Non-Enrolled||G593 + Q593||$13.00+$5.60 = $18.60|
|With Other Services||All Models||Enrolled & Non-Enrolled||G593 + Visit Fee||$13.00 + visit fee|
* includes Family Health Organizations, Family Health Networks, Group Health Center, Rural and Northern Physician Group Agreements, Weeneebayko Area Health Authority, Saint Joseph’s Health Center, Toronto Palliative Care Agreements, GP Focus Care of the Elderly, GP Focus HIV, Homeless Shelter Agreements, Sioux Lookout Agreements, and Community Sponsored Agreement/Blended Salary Model.
Subsequent booster COVID-19 immunization doses are not covered by this agreement but will be negotiated at a later date with the Ministry.
There is also an option for a physician office to be designated by the ministry as an eligible COVID-19 assessment centre, when vaccine delivery is coordinated by a hospital/ public health unit which would enable physicians to alternatively claim the H409/H410 sessional codes for these services. Any such arrangement requires the agreement of the physician group.
A tracking code, Q007, will be established at a value of $6.00 which is payable only in the event that physicians receive a formal request from a public health unit or the province to contact identified groups of patients to assist in the registering and/or booking of their COVID-19 vaccinations, or to provide direct assistance in completing patient consent or other documentation related to COVID vaccination.
This fee of $6 is NOT payable when physicians administer the vaccine to the patient nor when physicians only provide general information about how to access or register for a vaccination.
The patient facilitation fee may only be billed once per patient for the 12-month period of this agreement. Physicians will be required to submit a tracking code for each patient for whom the facilitation fee is rendered. The Ministry will make a single payment for all eligible claims submitted by physicians for the patient facilitation activities and the payment will be made within 15 months of the date of agreement.
Bill H409 for weekdays and H410 for after hours and weekends Note this is hourly rather than patient based, and a universal “dummy” patient can be used to link to.