All codes
Y860
Y860 – Y860
OHIP Other Code · Schedule of Benefits
When to Use
- Use Y860 as the mandatory administrative code when billing for the completion of a third-party form, such as a sick note or insurance document, where the fee is paid by the patient or a third party rather than OHIP.
- Apply this code in conjunction with a private fee charge to indicate that the service provided is non-insured and the patient has been informed of the associated cost.
Common Pitfalls
- Billing Y860 alongside an OHIP-insured service code (like A007) for the same patient encounter will trigger a rejection because the code is specifically for non-insured services.
- Failing to include the appropriate diagnostic code or the specific third-party form description can lead to confusion during internal practice audits regarding why a zero-dollar claim was submitted.
Billing Tips
- Ensure your EMR is configured to flag Y860 as a 'non-insured' service to prevent it from being erroneously submitted to the Ministry of Health as a billable claim.
Provider Fee$0.00
Surgical Assistant Fee$199.65
Non-Anaesthetist Fee$112.32
Effective: April 1, 2026
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