OHIP block fee

Topics: Physical examination, Medical history, Medical record Pages: 7 (583 words) Published: February 9, 2014
2013 GUIDE TO FEES FOR UNINSURED SERVICES (Visit UninsuredServices.ca) Charge for Note completion may consist of up to three (3) separate components and their summation is the total cost EXAMINATION

FEE

HOURLY FEE
For CHART REVIEW

+

+

FORM
FEE

TOTAL
FEE

=

HOURLY CHARGE - hourly charge calculated as per the OMA 2013 Guide to Third Party & Other Uninsured Services (www.oma.org). 15 min minimum charge may apply. Administrative License Suspension Appellant Medical

Information Form
Admission to Daycare Physical Forms

$45.00
$30.00

Appearance Before Advisory Review Board or Review Board
Approval of an Assessment or Examination (#OCF – 22)
Attending Physician Statement
Auto Sales Tax Rebate Form
Back to Work Notes/Sick Notes
Camps Physical Forms
CAS Application for Prospective Foster Parents

$30.00
$55.00

Central Collection Service Request for Physician’s Information Certificate of Health Practitioner (#OCF-8)
Certification of Incompetence (Financial)
Certification Procedures Regarding Management of Estate
Chart Demand Surcharge
less

$146.90/ ½ hr
$125.00
$129.45
$40.00
$25.00

1 day or
< 2 days
< 4 days
< 7 days

Citizenship & Immigration Canada Medical Report for
Immigration
Civil Aviation Medical Examination Report 26-0010E (001004)
Clarification Report – Life & Health Insurance
Completion of Forms and Procedures Dictated to the Mental
Health Act
Court Appearance
CPP Disability Medical Report Form
Day Care Sick Note (free of communicable disease)
Determination of Catastrophic Impairment (#OCF-19/59)
Diagnostic Interview and/or Counselling with Child and/or
Parent for Testing
Disability Certificate (#OCF-3)
Disability Medical Report CPP Form

$125.00
$45.00
$269.75
Independent
Consideration
$130.00
$105.00
$80.00
$55.00
$125.00
$85.00
$348.90/hr
Independent
Consideration
Per hourly rate
$125.00
$25.00
$105.00
$130.00/ ½ hr

Missed Appointments Without 24hr Cancellation
Motor Vehicle Accident Forms
Narrative Medical CPP Form
NSF Cheques
Orthotics, Massage Therapy, Weight Loss,
Physiotherapy Referral Form
Patient Interview for Practice Admission
Photocopying
First 25
pages
Additional Pages (26+)
Pilots License Validation 26-0055(01-91)
Pre-adoption Examination and Evaluation for CAS
Pre-employment Certificate of Fitness Clubs Physical
Forms
Preparation & attendance at Board of Review

$90.00
$160.00
$1.20 / pg
$25.00
$193.45
$40.00
$891.70

Respite Form

$30.00

Request for Medical Information re: Applicants to
Canadian Armed Forces

$100.00

Revenue Canada, Federal Disability Tax Credit

$45.00

Small Skin Lesions Removal
Skin Tag or Other Benign Lesion - $20.00 per treatment
Including Freezing/Suture - $25.00 - $55.00 per lesion
Specific Assessment with Report to Referring Agency
$294.50
– Psychiatry
System-Specific Examination
$100.00
System-Specific or Disease Specific Questionnaire
$85.00
Prescription or Repeats by Phone or Fax
$20.00 / med

$14.10
$55.00
$55.00

Federal Employee Absence Notes

$30.00

Transfer of Medical Records – Psychiatric Nature

Insurance Medical Examination
Life Insurance Death Certificate
Long Distance Phone or Fax on Patient Behalf
Medical Certificate Employment Insurance Sickness Benefits
INS5140

at cost, plus 50% for
overhead
$30 - $105
Per hourly rate
Up to $160.00
$35
$25.00

Per hourly rate

Dispensing Service Fee
Drivers Medical Examination (FLRC80) (+physical exam Fee
$150 if between ages of 18 to 64)
Emergency Telephone Consultation – Obs/Gyn

$348.90/hr
$35.00
Independent
Consideration
$211.40
$45.00
$20 minimum
$30.00

$50.00

Reports..Medical..Legal..

TB Mantoux Test
Telephone Advice During Office Hours – after hours
higher rate
Test Results by Phone by Office Staff
Therapeutic Supervision with any Paramedical
Organization
Transfer of Medical Records

Full Narrative Report – Life & Health...
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