See Article Training or Experience Required to Claim Certain Tariffs

Eligible for tariff 8380 in community-based clinics, and 15% premium when provided in hospital.

Initial assessment requires complete medical history, substance use history and appropriate targeted physical examination. If assessment and induction are done on the same day, withdrawal assessment using COWS or SOWS and administration of first dose of OAT are included.

1) Payable to a maximum of 4 units per patient/​per day/​per intended induction.

2) Payable only to the physician who intends to provide or share management of the patient’s OAT induction for opioid use disorder.

3) Start time must be entered in both the billing claim and patient’s chart.

4) No other visit fees are billable on the same day except 8376, RACE tariffs and conferences. 8376, RACE tariffs and conferences are payable in addition to 8375 only when not performed concurrently.

5) Payable for assessment for change of OAT with induction to a different medication.

6) May not be repeated within 30 days by the same physician.

7) This service is payable only for physician time spent on patient assessment (and on administration of first dose of OAT if provided same day).

This fee is payable for individual interactions with the patient during the first three days of OAT induction for opioid use disorder within the limits described in the following notes.

1) Billable in addition to 8375, or a same day visit or consultation fee (in-
person, telephone or video conference) when not performed concurrently.

2) Billable up to 3 times on day of first dose of OAT.

3) Billable up to 2 times on day 2 of OAT induction.

4) Billable once only on day 3 of OAT induction.

5) May be provided in-person, by telephone, or by video conference.

6) May be billed when delegated to a nurse employed within, the eligible
physician practice.

7) Start time must be entered in both the billing claim and patient’s chart.

1) Restricted to patients in opioid agonist treatment.

2) Maximum billable: 26 per annum, per patient.

3) Confirmatory testing (reanalyzing a specimen which is positive on the initial POC test using a different analytic method) is expensive and seldom necessary once a patient is in treatment for opioid use disorder. Accordingly, confirmatory testing should be utilized only when medically necessary and when a confirmed result would have a significant impact on patient management.

4) This tariff includes the adulteration test.

5) Only POC urine testing kits that have met Health Canada Standards
are to be used.

1) Not billable for patients in opioid agonist treatment.

2) Maximum billable: 26 per annum, per patient:

3) Confirmatory testing (reanalyzing a specimen which is positive on the initial POC test using a different analytic cmethod) is expensive and seldom necessary once a patient is in treatment for opioid use disorder. Accordingly, confirmatory testing should be utilized only when medically necessary and when a confirmed result would have a significant impact on patient management.

4) This tariff includes the adulteration test.

5) Only POC urine testing kits that have met Health Canada Standards are to be used.

1) The physician does not necessarily have to have direct face-to-face contact with the patient for this fee to be paid.

2) 8377 is the only fee payable for any medically necessary service associated with maintenance opioid agonist treatment for opioid use disorder. This includes but is not limited to the following:

• At least one visit (in person, telephone, or video conference) per month with the patient after induction/​stabilization on opioid agonist treatment is complete.
• At least one in-person visit with the patient every 90 days. Exceptions to the criterion will be considered on an individual basis.
• Supervised urine drug screening and interpretation of results.
• Simple advice/​communication with other allied care providers involved in the patients OAT.

3) Claims for treatment of co-morbid medical conditions, including psychiatric diagnoses other than substance use disorder, are billable using the applicable visit fees. Counselling and visit fees related only to substance use disorder are not payable in addition.

4) This fee is payable once per week per patient regardless of the number of services per week for management of OAT maintenance.

5) After hours premiums are not payable in addition.

6) Eligibility to submit claims for this tariff is limited to physicians who are actively supervising the patient’s continuing use of opioid agonist medications for treatment of opioid use disorder.

7) This payment stops when the patient stops opioid agonist treatment