All codes
Y811
Y811 – Y811
OHIP Other Code · Schedule of Benefits
When to Use
- Use Y811 as a mandatory administrative tracking code when submitting claims for the Chronic Disease Management Incentive (K030).
- Apply this code to indicate the completion of a comprehensive care plan for patients with eligible chronic conditions as required by the Ministry of Health.
Common Pitfalls
- Failing to link Y811 to the corresponding K030 service code will result in an automatic rejection of the incentive payment.
- Using Y811 in isolation without an associated valid chronic disease management service code is a common cause for claim audit flags.
Billing Tips
- Ensure Y811 is submitted on the same claim record as the K030 to satisfy the Ministry's validation requirements for the incentive.
Provider Fee$0.00
Surgical Assistant Fee$110.45
Non-Anaesthetist Fee$56.23
Effective: April 1, 2026
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