All codes
Y852
Y852 – Y852
OHIP Other Code · Schedule of Benefits
When to Use
- Use Y852 when submitting a claim for a non-insured service or a service where the physician is permitted to bill the patient directly rather than OHIP.
- Apply this code to indicate a zero-dollar claim for administrative purposes, such as when documenting a service that has no fee associated with the OHIP schedule.
Common Pitfalls
- Do not use Y852 as a substitute for a billable service code; it does not generate payment and will be rejected if used to bypass standard fee-for-service requirements.
- Avoid using this code for services that should be billed under a specific diagnostic or procedural code, as it provides no audit trail for the clinical work performed.
Billing Tips
- Ensure Y852 is only submitted when the billing system requires a placeholder code for non-OHIP billable encounters to maintain accurate patient records.
Provider Fee$0.00
Surgical Assistant Fee$206.25
Non-Anaesthetist Fee$73.52
Effective: April 1, 2026
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