Information for Supplementary Benefit Practitioners

Important Notice:
Effective June 1, 2006, the Office of the Superintendent of Motor Vehicles (OSMV) will pay for certain driver fitness assessments including Driver Medical Examination forms required for people with medical conditions. See the information below, under Optometry Payment Schedule and Billing Guide, for details.

Many supplementary benefits practitioners are opted-out of the Medical Services Plan (MSP). This means they are allowed to charge patients more for a service than is set out in the Payment Schedule.

Opted-out practitioners must advise their patients, prior to the treatment being performed:

  • that they have opted out;
  • how much is reimbursed by MSP; and
  • how much the patient will be paying in addition to the MSP fee.

MSP Guidelines for Hard and Soft Opt Out Status (PDF  89K) - requirements for opting out of MSP and implications for billing.

Payment Schedules and Billing Guides

Only those MSP beneficiaries with premium assistance status qualify for MSP coverage of acupuncturist, physiotherapy, massage therapy, chiropractic, naturopathy and non-surgical podiatry services. To verify a patient's eligibility for these benefits, use the Teleplan online eligibility check feature or call Coverage Enquiries. The MSP fee items for eligible beneficiaries are:

 00142Acupuncture service
(effective April 1, 2008)
 00138Chiropractic service$23.00 
 09948Massage therapy service$23.00
 00145Naturopathy service$23.00
 09938Physiotherapy service$23.00
 00189Podiatry service (non-surgical)$23.00
(i) These items are applicable only to patients who have premium assistance status.
(ii) Subject to (i) above, acupuncturist, chiropractic, massage therapy, naturopathic, physiotherapy and non-surgical podiatry services are benefits up to a combined maximum of 10 visits per patient per calendar year.

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