OHIP Fee Code Updates: What Changed in 2026

The Ontario Schedule of Benefits (SOB) is a living document. The Ministry of Health updates it periodically — adding new codes, adjusting fees, modifying rules, and occasionally removing codes entirely. Staying current is essential for accurate billing.

Here's what Ontario physicians need to know about recent changes.

How the SOB Gets Updated

The Schedule of Benefits is updated through several mechanisms:

• Physician Services Agreement (PSA): Negotiated between the OMA and the Ministry, the PSA sets overall fee adjustments. The most recent agreement included across-the-board increases.
• INFOBulletins: The Ministry publishes INFOBulletins to announce specific code changes, new codes, and rule modifications.
• Schedule revisions: Periodic republication of the full SOB PDF with accumulated changes.

What This Means for Your Billing

When fee codes change, several things can happen:

Fee Increases

When a code's fee goes up, claims submitted after the effective date are paid at the new rate. Claims for services provided before the change use the old rate — even if submitted after the update.

New Codes

New codes are added to reflect evolving medical practice. If a new code better describes a service you provide, switching to it can mean higher reimbursement.

Deleted Codes

When a code is removed, claims using it after the deletion date will be rejected. There's usually a replacement code or a transition period. Understanding these changes is key to avoiding claim rejections.

Rule Changes

Sometimes the fee stays the same but the rules change — new diagnostic code requirements, different maximum frequencies, or modified eligibility criteria.

Staying Current

Manually tracking SOB changes is tedious. Most physicians rely on their billing platform or billing agent to keep up with updates.

SnapBill monitors the Schedule of Benefits continuously and updates its validation rules automatically. When a code changes, your claims are validated against the current rules — not last month's.

You can also browse the full Schedule of Benefits on our billing codes reference, which is updated regularly.

Pro Tips

1. Review INFOBulletins monthly: The Ministry publishes them regularly. Even a quick scan keeps you informed.
2. Check your rejection rates after updates: A spike in rejections often correlates with SOB changes you missed.
3. Use current-year codes: Some codes have vintage — make sure you're using the active version.
4. Verify with the SOB directly: When in doubt, the Schedule of Benefits PDF is the authoritative source.

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