Business Hours: Weekdays 8:00am to 5:00pm EST

OHIP Billing Codes


In a Medical Billing and Coding profession you will be in charge of processing patient data, such as treatment records and related insurance information. Medical Insurance billers and coders are tasked with coding a patients’ diagnoses along with a request for payments from the patient’s insurance company. Working in healthcare is very rewarding, they are vital to keeping cost down, reducing medical mistakes and generally insuring there is a free flow of information about patient’s medical histories. That’s why medical billing and coding Specialist are so essential. Making sure data is prompt and accurate is a core part of the job credentials. By becoming a medical billing and coding specialist you will be saving a lot of lives.

The medical insurance plan for residents of Ontario is operated by the Ontario Ministry of Health and Long Term care. The government goal to establish such an insurance plan was to guarantee the availability of a minimum level of affordable health care insurance for all residents of Ontario regardless of income. In January 1990 new policy was introduced where employers would pay a percentage fee based on employee wages to the Treasure on Ontario (EHT) which replaced the Ontario Health Insurance Plan (OHIP). With introduction of EHT, employee health tax, Ontario residents would continue to receive health care coverage, but no longer be required to pay OHIP premiums.

K.C. McKee provides a number of opportunities for the billing services of doctors. It is becoming a trusted source for the doctors of Ontario for its excellent service.  

Types of Physician Services

 Call or visit: The service provided by a physician to a patient for assessment and/or treatment.

  • Laboratory Test: Seldom billed by a private physician.
  • Diagnostic tests/procedures: may include a technical fee for performing the procedure. Professional fee for the interpretation of the results in a written report.
  • Surgical procedures: Include fees for the surgeon, fees for the assisting surgeon and anesthetist based on time unit calculations.
  • Special travel/premiums/ visits: Include fees for the physician when a special call or visit to a patient which is beyond the regular working hours.

Basket of Codes

  • Codes that can be billed which provide premiums, bonuses and payments. Each group has own specific basket of codes.
  • Codes that are out of basket are paid at the fee-for-service rate from the schedule of benefit. i.e. K037A (chronic fatigue) would be paid as 62.75. WSIB, RMB are exempt from the basket and are paid fee for A007, G365A as usual.
  • Q130 flu shot Q011 pap smears.
  • Q131A mammography.
  • Q132A Childhood immunization Q133A colorectal cancer.
  • Each code is billed as $0.00 dollar and at the end of fiscal year (March 31) based on the total number of tracking code used, a yearly incentive bonus will be paid to the doctor.
  • If patients went to pharmacy or other clinic to have their flu shot or mammogram, the doctor can bill the tracking code as long as the patient informs the doctor that it was done.
  • Bipolar Q020A.
  • Schizophrenia Q021A.
  • Q040A Diabetes Flow Sheet.
  • Q050A Congestive Heart Failure Flow sheet
  • Q152A FOBT completion of test and review by the physician.
  • Q042A Smoking Cessation Counseling sessions.

Medical specialists have a practice which is divided between hospital in-patient and out-patient care as well as regular private office visits. The proportion of each type of billing depends on the area of specialty and whether there is an affiliation with local hospital as a staff physician. Patients are seen by medical specialists after a referral form the family/general practitioner or another specialists, who has determined the patient’s need for special investigation. K.C. McKee creates a buildup communication and helping hand in these regards.

K.C. McKee have maintained an excellent track record and is continuing in their level best to improve in their activities and upgrade as much as possible. Services are being improved to reach the specified objectives for future development.

Call Us Now and use our billing services!