A roundup of the latest updates to OHIP billing codes

There have been a number of recent changes to OHIP billing codes that Ontario physicians should know about.As of April 1, 2026, there are major schedule codes for emergency department after-hours services.H113A, a premium code previously reserved for daytime and evenings on weekends or statutory holidays, is now billable on Friday evenings. Friday evenings are also now eligible for H151A, H152A, H153A and H154A codes that were previously only eligible for weekends and holidays. The province has also introduced a new fee code H114A to cover evening after hours service during Mondays to Thursdays. In addition, there’s a new fee code for emergency department pelvic exams: H264A. There are also fee code updates to align with the ColonCancerCheck recommendations to lower the colorectal cancer screening age from 55 to 45. For people with an increased risk of colon cancer due to family history, the recommendations state that screening should be repeated every five years starting at age 40. Thus, the clinical parameters of fee codes Z492, Z493, Z498 and Z499 have been updated to reflect these recommendations.These changes took effect on July 1, 2026, although some physicians delayed submitting these claims while system updates were taking place. As of Aug. 1, physicians who delayed submission of these eligible claims can now submit these claims.For anesthesia providers, a new fee code has been implemented to deliver a tiered daily stipend for time spent delivering qualifying anaesthesia services in hospital settings. As of April 1, 2026, anesthesiologists and family practice anesthetists can claim code H010A.Finally, the descriptors of certain codes relating to frontal sinusotomy and denervation services have been updated. For frontal sinusotomy, the code descriptions for Z318, M050 and M052 have been updated to specify Draf classifications. The code descriptions for denervation services (R426 and R427) have also been updated updated to align with peripheral nerve fee listings.

A roundup of the latest updates to OHIP billing codes

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