OCA Fee Schedule

The OCA Recommended Service Codes and Fee Schedule (“The Fee Schedule”) has been prepared for chiropractors, patients and payers to provide for fair and reasonable billing for chiropractic services according to a clear and consistent model.

The schedule is comprehensive, covering general and specialist chiropractic services. The OCA has published the Fee Schedule since the early 1970s. The structure and content of the schedule has changed over the years to reflect the needs of practitioners, patients and payers.

Recommended fees are adjusted periodically to reflect changes in the cost of rendering care and in the socio-economic circumstances of the day. The adjustments made to the guide over the past decade have been in line with general inflation.


Fee Schedule Update: Reasonable Cost Recovery for Disclosing Health Records

As a chiropractor, when you provide a copy of a health record, you may charge a fee for this service. The Personal Health Information Protection Act (PHIPA) limits fees for copies of records to “reasonable cost recovery”. This phrase was not originally defined in dollar amounts, and the OCA Recommended Service Codes and Fee Schedule included recommended fees for copying records.

The Information and Privacy Commissioner of Ontario (IPCO) has now provided a set of fee maximums which health information custodians must adhere to when accessing and disclosing health records. Members are to refer to these fee maximums when providing copies of health records. Our 2017 Fee Schedule will reflect this new set of fee maximums.

These IPC rulings stem from complaints regarding fees charged by physicians and hospitals, but apply to all health information custodians including chiropractors.

Fees You Charge When Providing Copies

In Health Order 9 and Health Order 14, the IPCO established that “reasonable cost recovery” for accessing and disclosing health information shall not exceed $30 for any or all of the following services:

  1. Receipt and clarification, if necessary, of a request for a record.
  2. Providing an estimate of the fee that will be payable under subsection 54(10) of the Act in connection with the request.
  3. Locating and retrieving the record.
  4. Review of the contents of the record for not more than 15 minutes by the health information custodian or an agent of the custodian to determine if the record contains personal health information to which access or disclosure may or shall be refused.
  5. Preparation of a response letter.
  6. Preparation of the record for photocopying, printing or electronic transmission.
  7. Photocopying the record to a maximum of the first 20 pages or printing the record, if it is stored in electronic form, to a maximum of the first 20 pages, excluding the printing of photographs from photographs stored in electronic form.
  8. Packaging of the photocopied or printed copy of the record for shipping or faxing.
  9. If the record is stored in electronic form, electronically transmitting a copy of the electronic record instead of printing a copy of the record and shipping or faxing the printed copy.
  10. The cost of faxing a copy of the record to a fax number in Ontario or mailing a copy of the record by ordinary mail to an address in Canada.
  11. Supervising examination of the original record for not more than 15 minutes.

In addition to the fee charged above, fees for the services set out in Column 1 of the Table below shall not, for the purposes of subsections 35(2) and 54(11) of the Act, exceed the amounts set out opposite the service in Column 2 of the Table below.

ITEM

COLUMN 1

COLUMN 2

1. For making and providing photocopies or computer printouts of a record 25 cents for each page after the first 20 pages
2. For making and providing a paper copy of a record from microfilm or microfiche 50 cents per page
3. For making and providing a floppy disk or a compact disk containing a copy of a record stored in electronic form $10
4. For making and providing a microfiche copy of a record stored on microfiche 50 cents per sheet
5. For making and providing a copy of a microfilm of a record stored on microfilm that is,
i. 16 mm $25 per reel
ii. 35 mm $32 per reel
6. For printing a photograph from a negative or from a photograph stored in electronic form, per print,
i. measuring 4” x 5” $10
ii. measuring 5” x 7” $13
iii. measuring 8” x 10” $19
iv. measuring 11” x 14” $26
v. measuring 18” x 20” $32
7. For making and providing a copy of a 35 mm slide $2
8. For making and providing a copy of an audio cassette $5
9. For making and providing a copy of a ¼”, ½” or 8 mm video cassette,
i. that is one hour or less in length $20
ii. that is more than one hour but not more than two hours in length $25
10. For making and providing a copy of a ¾” video cassette,
i. that is not more than 30 minutes in length $18
ii. that is more than 30 minutes but not more than one hour in length $23
11. For producing a record stored on medical film, including x-ray, CT and MRI films $5 per film
12. For the review by a health information custodian or an agent of the custodian of the contents of a record to determine if the record contains personal health information to which access or disclosure may or shall be refused $45 for every 15 minutes after the first 15 minutes
13. For supervising examination of original records $6.75 for every 15 minutes

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Fees You Pay When Collecting Copies

Members have reported to us that hospitals charge a range of fees ($0–$100) when providing copies of x-rays and other health records. We believe that Health Orders 9 and 14 mean that the fees charged by hospitals are subject to the same definition of “reasonable cost recovery” listed above and are legally limited to the same fee maximums. As a first step, we are preparing to meet with the Ontario Hospital Association. We report back to you when we have more information.

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Do Not Pass Collection Fees On To Patients

The IPC has asked us to advise our members that while PHIPA allows health information custodians to charge a cost recovery fee for accessing and disclosing health records, it prohibits health custodians from charging for collecting or using health records.

In practice, this means:

  • If a patient or patient representative (e.g. a lawyer) requests a copy of their health record, you may charge a fee as outlined above for disclosing the record.
  • If another health practitioner requests a copy of a patient’s health record, you may charge a fee as outlined above for disclosing the record. They may not pass this fee on to the patient, because they may not charge for collecting the record.

If a hospital charges you a fee when they disclose a patient record to you, you may not pass this cost on to the patient because you may not charge for collecting the record.

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