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Y815

Y815Y815

OHIP Other Code · Schedule of Benefits

When to Use

  • Use Y815 as the mandatory diagnostic code when billing for the administration of the COVID-19 vaccine to patients who do not have a valid OHIP number.
  • Apply this code specifically for uninsured patients receiving the immunization to ensure the encounter is tracked correctly by the Ministry without requiring a standard health card number.

Common Pitfalls

  • Do not use Y815 for patients who possess a valid OHIP card, as this will trigger a rejection; use the standard diagnostic code for the vaccine administration instead.
  • Avoid using Y815 as a primary diagnosis for general office visits, as it is strictly reserved for the specific administrative tracking of uninsured COVID-19 immunizations.

Billing Tips

  • Ensure the patient's demographic information is entered as 'Uninsured' in your EMR to prevent the system from defaulting to standard OHIP validation checks that conflict with this code.
Provider Fee$0.00
Surgical Assistant Fee$152.95
Non-Anaesthetist Fee$59.61

Effective: April 1, 2026

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