How to add age premiums to your OHIP claim

Question:

How do I enter the age-related premiums in your system?

Answer:

This is mainly for physicians who are providing anesthesia services, which allows them to claim additional units based on the patient's age. These additional units are outlined in the Schedule of Benefits, page GP95.

The following codes are now automated for payment purposes (as of June 1, 2008).

E014C - newborn to 28 days

E009C - 29 days to a year

E019C - 1 year to 8 years inclusive

E007C - adult 70 - 79 inclusive

E018C- adult 80 and older

For service dates on or after June 1, 2008, it’s no longer necessary to submit these fee codes for payment, as the extra units will be calculated and paid automatically.
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Any fee codes submitted with service dates on, or after June 1, 2008, will be paid at $0 with explanatory code 30 (This Service is Not a Benefit of OHIP).

Payment for all age premiums will appear under "Accounting Transactions" on the Claim Summary Payment report with the description “Anaesthetic Age Premium”.

Note: E021C (premature newborn less than 37 weeks gestational age) has not been automated and should continue to be claimed as part of claims submission.