A320

PDF page 130 / A2

Payment rules:
     1.With the exception of A945/C945, any other services listed under the "Family Practice &
       Practice in General" in the "Consultations and Visits" section of the Schedule are not eligible
       for payment when rendered with this service.
     2.Start and stop times must be recorded in the patient's permanent medical record or the
       service will be adjusted to a lesser paying fee.
     3.When the duration of A945 or C945 exceeds 50 minutes, one or more units of K023 are
       payable in addition to A945 or C945, provided that the minimum time requirements for K023
       units occurs 50 minutes after the start time for A945 or C945.
     4.This service is claimed in units. Unit means ½ hour or major part thereof - see General
       Preamble GP7, GP55 for definitions and time-keeping requirements.
   Special Medical Assistance in Dying consultation
     A special Medical Assistance in Dying (MAID) consultation is a consultation conducted for the
     purpose of assessing the eligibility for MAID in a patient who has submitted a written request
     for MAID. This service is a consultation rendered by a physician who provides all the elements
     of a consultation and spends a minimum of fifty (50) minutes of direct contact with the patient
     exclusive of time spent rendering any other separately billable intervention to the patient. A320
     includes the preparation and transmission of all necessary documentation.
 A320 Special Medical Assistance in Dying (MAID) consultation ......                  174.25
     Payment rules:
     1.Start and stop times must be recorded in the patient’s permanent medical record.
     2.When the duration of a special MAID consultation (A320 or C320) exceeds 50 minutes, one
       or more units of K321 are payable in addition to A320 or C320, provided that the minimum
       time requirements for K321 are met. The time periods for A320 or C320 and K321 are
       mutually exclusive (i.e. the start time for determination of minimum time requirements for
       K321 occurs 50 minutes after start time for A320 or C320).
   Medical Assistance in Dying support
     Medical Assistance in Dying (MAID) support is a time-based service payable for providing
     MAID assessment, support and counselling to patients requesting MAID, and provision of
     MAID by a physician. MAID support is only eligible for payment when rendered personally by
     the physician.
 K321 Medical Assistance in Dying (MAID) support...............per unit           85.25

PDF page 131 / A3

CONSULTATIONS AND VISITS
 FAMILY PRACTICE & PRACTICE IN GENERAL (00)
          Payment rules:
          1.This service is claimed in units. Unit means ½ hour or major part thereof - see General
            Preamble GP7, GP55 for definitions and time-keeping requirements. Start and stop times
            must be recorded in the patient's permanent medical record. Minimum time requirements can
            be consecutive or non-consecutive time on the same day.
          2.When the duration of A320 or C320 exceeds 50 minutes, one or more units of K321 are
            payable in addition to A320 or C320, provided that the minimum time requirements for K321
            units occurs 50 minutes after the start time for A320 or C320.
          3.K321 is payable to a maximum of two physicians, same patient same day.
          4.With the exception of A320/C320, no other insured services or premiums are eligible for
            payment during the same period of time when MAID support is claimed.
          5.K321 is payable in circumstances where the patient is found to be ineligible for MAID on the
            day of planned MAID intervention or where the patient does not provide consent for MAID
            intervention.
          Claims submission instructions:
          Claims in excess of 12 units by the same physician for the same patient should be submitted
          using the manual review indicator and accompanied by supporting documentation.
          [Commentary:
          1.The CPSO has established guidance, which lay out a number of safeguards for the provision
            of MAID in Ontario. For further information related to the provision of MAID in Ontario,
            physicians should refer to the CPSO’s website (http://www.cpso.on.ca/).]
   A905 Limited consultation ................................................................   80.15
   A006 Repeat consultation ................................................................    47.10

PDF page 140 / A12

Non-Emergency Hospital In-Patient Services
     See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
     patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
     GP78.
 C005 Consultation............................................................................  95.60
 C911 Special family and general practice consultation - subject to the
          same conditions as A911....................................................          164.95
 C912 Comprehensive family and general practice consultation -
          subject to the same conditions as A912 .............................                 247.40
 C945 Special palliative care consultation - subject to the same
          conditions as A945 .............................................................     174.25
 C320 Special Medical Assistance in Dying (MAID) consultation -
          subject to the same conditions as A320 .............................                 174.25
 C905 Limited consultation ................................................................     81.25
 C006 Repeat consultation ................................................................      47.10
 C003 General assessment...............................................................         89.65
 C004 General re-assessment ..........................................................          38.35
 C813 Midwife or Aboriginal Midwife-Requested Assessment -
        subject to the same conditions as A813 .............................                                 111.70
 C815 Midwife or Aboriginal Midwife-Requested Special Assessment
        - subject to the same conditions as A815...........................                                  186.95
 C933 On-call admission assessment - subject to the same conditions
        as A933 ..............................................................................                 82.00
 C777 Intermediate assessment - Pronouncement of death - subject
         to the same conditions as A777 .........................................                              44.55
 C771 Certification of death - subject to the same conditions as A771                                          24.20

PDF page 194 / A66

CONSULTATIONS AND VISITS
VIRTUAL CARE SERVICES
   DEFINITIONS:
    For the purposes of this section of the Schedule only, the following Definitions apply:
     Comprehensive Virtual Care Service means a Virtual Care Service rendered where an
     Existing/Ongoing Patient-Physician Relationship exists, and in the physicians’ professional
     opinion in accordance with accepted professional standards and practice, the person's care
     and support requirements can be effectively and appropriately delivered by Video or
     Telephone.
     Existing/Ongoing Patient-Physician Relationship means:
 1. Where a physician is providing a Virtual Care Service to a patient where there has been at least
    one insured service with a direct physical encounter between the patient and that physician
    (Family and General Practice Physician or specialist) in the preceding 24-months; or
 2. Where a physician is providing a Virtual Care Service to a patient who has signed the MOH’s
    Patient Enrollment and Consent to Release Personal Health Information form and is enrolled to
    that physician or another physician within the same group (who is signatory/locum to a MOH
    alternate funding plan agreement); or
 3. Where a specialist or GP Focused Practice Physician is providing a consultation by Video set
    out in Appendix J – Section 1, or has provided any such consultation in the preceding 24-
    months to that patient; or
     [Commentary:
     Where the visit leading to the referral for consultation has occurred virtually, it would be
     expected that the referring physician has an established relationship with the patient and that
     the clinical issue leading to the referral has been assessed in-person within the previous 12-
     months.]
     [Commentary:
     Where a physician who has been paid for a consultation for the patient for the same diagnosis
     makes a request for a referral for ongoing management of the patient, the service rendered
     following the referral is not payable as a consultation, unless the request for referral, if the
     referral is made, allows for an ongoing patient physician relationship in the context of a
     consultation by Video.]
 4. Where a physician provides any of the following services, or has provided any of the following
    services in the preceding 24-months:
            •   A920 – Medical management of early pregnancy - initial service by Video or
                Telephone,
            •   A945/C945 – Special palliative care consultation by Video,
            •   A320/C320 - Special Medical Assistance in Dying (MAID) consultation by Video,
            •   A680/C680 – Initial assessment - substance abuse by Video,
            •   A814, A817, A818 – Midwife or Aboriginal Midwife-Requested Assessments
                (MRAs) by Video,
            •   A802 – Extended midwife or Aboriginal Midwife-requested genetic assessment by
                Video,

PDF page 826 / AJ2

APPENDIX J
VIDEO ONLY
     A010A, A011A, A015A, A016A, A021A, A025A, A026A, A035A, A036A,
     A045A, A046A, A050A, A055A, A056A, A065A, A066A, A075A, A076A,
     A085A, A086A, A095A, A096A, A116A, A130A, A135A, A136A, A150A,
     A155A, A156A, A160A, A165A, A166A, A175A, A176A, A180A, A185A,
     A186A, A190A, A191A, A192A, A195A, A196A, A197A, A198A, A205A,
     A206A, A210A, A220A, A223A, A225A, A226A, A235A, A236A, A245A,
     A246A, A253A, A255A, A256A, A260A, A265A, A266A, A275A, A285A,
     A286A, A315A, A316A, A320A, A325A, A335A, A345A, A346A, A355A,
     A356A, A365A, A375A, A385A, A395A, A400A, A405A, A415A, A416A,
     A425A, A435A, A445A, A446A, A460A, A465A, A466A, A470A, A475A,
     A476A, A485A, A486A, A515A, A525A, A545A, A565A, A575A, A580A,
     A586A, A590A, A595A, A600A, A605A, A606A, A615A, A616A, A625A,
     A626A, A635A, A636A, A645A, A646A, A655A, A662A, A665A, A667A,
     A675A, A680A, A682A, A695A, A710A, A715A, A720A, A725A, A726A,
     A735A, A745A, A770A, A775A, A795A, A800A, A801A, A802A, A814A,
     A817A, A818A, A835A, A845A, A865A, A906A, A913A, A914A, A915A,
     A925A, A935A, A945A, C010A, C013A, C014A, C015A, C016A,
     C020A, C023A, C024A, C025A, C026A, C033A, C034A, C035A, C036A,
     C043A, C044A, C045A, C046A, C051A, C053A, C054A, C055A, C063A,
     C064A, C065A, C066A, C071A, C073A, C074A, C075A, C076A, C083A,
     C084A, C085A, C086A, C093A, C094A, C095A, C096A, C111A, C113A,
     C114A, C116A, C130A, C131A, C133A, C134A, C135A, C136A, C150A,
     C151A, C153A, C154A, C155A, C156A, C160A, C161A, C163A, C164A,
     C165A, C166A, C173A, C174A, C175A, C176A, C180A, C181A, C183A,
     C184A, C185A, C186A, C190A, C193A, C194A, C196A, C203A, C204A,
     C205A, C206A, C210A, C220A, C223A, C225A, C226A, C233A, C234A,
     C235A, C236A, C243A, C244A, C245A, C246A, C255A, C260A, C263A,
     C264A, C265A, C266A, C270A, C275A, C283A, C285A, C286A, C311A,
     C313A, C314A, C315A, C316A, C320A, C325A, C335A, C341A, C343A,
     C344A, C345A, C346A, C353A, C354A, C355A, C356A, C365A, C375A,
     C385A, C395A, C411A, C413A, C414A, C415A, C416A, C425A, C435A,
     C441A, C443A, C444A, C445A, C446A, C460A, C461A, C463A, C464A,
     C465A, C466A, C470A, C471A, C473A, C474A, C475A, C476A, C480A,
     C481A, C483A, C484A, C485A, C486A, C510A, C511A, C515A, C545A,
     C565A, C570A, C575A, C580A, C585A, C586A, C590A, C595A, C600A,
     C601A, C603A, C604A, C605A, C606A, C611A, C613A, C614A, C615A,
     C616A, C623A, C624A, C625A, C626A, C635A, C643A, C644A, C645A,
     C646A, C655A, C661A, C662A, C665A, C667A, C675A, C680A, C682A,
     C695A, C720A, C721A, C723A, C724A, C725A, C726A, C710A, C713A,
     C715A, C735A, C745A, C760A, C770A, C775A, C795A, C845A, C865A,
     C895A, C915A, C925A, C935A, C945A, K630A, W025A, W026A,
     W075A, W076A, W130A, W150A, W155A, W156A, W165A, W185A,
     W190A, W196A, W235A, W236A, W275A, W310A, W355A, W356A,
     W375A, W395A, W425A, W435A, W465A, W466A, W510A, W511A,
     W515A, W516A, W535A, W720A, W725A, W726A, W770A, W775A,
     W795A, W895A, W925A

Master, record 165. Record Layout PDF, page 1.

A32020260401999999990000174250000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.