To be in compliance with the Canada Health Act, Manitoba physicians, like those in many other provinces, are prohibited from billing patients for the cost of disposable supplies (commonly referred to as ​“tray fees”) in connection with the provision of insured medical services.

Examples of disposable supplies that physicians will no longer be permitted to bill patients for are:

There are three tray fees available to be claimed with various procedures. Several existing procedures have upgraded to a higher tray fee level. In addition, tray fee rates have increased significantly, with a 20% increase for minor and major tray fees and over 70% for endoscopic.

• New Minor Tray Fees — the following procedures are now eligible for a minor tray fee: 0329, 4908, 4910, 7875 
• New Major Tray Fees — the following procedures are now eligible for a major tray fee: 0222, 0223, 1519, 1553, 1574, 1935, 1967, 1970, 1971, 2030, 2031, 5235 
  
• New Endoscopic Fees — the following procedures are now eligible for an endoscopic tray fee: 1949 and 4636 
• Upgraded to Endoscopic Tray Fee: 3926, 3927, 3928, 3929, 3931, 3932, 3933, 3339

Billing Notes

If the corresponding fee tariff for an insured medical service is not listed in one of the three new Tray Fee tariffs, a claim for a tray fee may not be submitted to Manitoba Health, nor may the patient be charged a tray fee.

Tray Fee tariffs will be claimable only in instances where expenses are directly incurred by the physician for medical /​surgical supplies. Tray Fee tariffs will not be claimable in relation to services performed at a hospital, personal care home or other publicly funded facility or a facility on contract with a Regional Health Authority to perform such insured services.

Physicians will continue to be permitted to bill patients directly for such items as: 

• orthotic devices
• slings
• splints
• braces
• IUDs
• laminaria tents
• casts
• tensor bandages
• radiopharmaceutical materials in connection with the provision of Nuclear Medicine services in private clinics in accordance with the College of Physicians and Surgeons By-Law #11, the charge to the patient for such items must not exceed the actual costs incurred by the physician.

Patients will continue to be responsible for the cost of prescription medications used in conjunction with insured medical services (e.g., therapeutic injections). This is the case whether the medication is purchased directly by the patient from a pharmacy, or whether the physician’s office purchases the medication on behalf of the patient, and thereafter seeks reimbursement from the patient for the cost of the medication.

Physicians continue to be prohibited from charging patients for such things as:

• cleaning/​sterilization of reusable equipment/​materials
• amortization/​cost apportionment of reusable equipment/​materials
• staffing costs
• utility and/​or other overhead costs