
A more detailed explanation:
The amount OHIP pays your doctor is set by a public document called the Schedule of Benefits.
It doesn’t literally say “one issue per visit”… but this is what actually happens:
- If you see your family doctor for a sore throat, they bill OHIP an “A007” fee code (an “Intermediate Assessment”). Under the new FHO+ model, that pays the doctor about $13.
- If, during the same visit, you also ask about knee pain, OHIP still only pays one A007 (just $13).
- If your doctor tries to bill a second A007 for the knee pain on the same day, OHIP rejects it.
- OHIP will only pay for one A007 fee code per patient per day.
But:
- If you come today for your sore throat (A007 = your doctor gets paid $13) and
- Come tomorrow for your knee pain (another A007 = your doctor gets paid another $13),
- OHIP pays for both—because they’re on different days. ($26 total).
Surprising but true: Whether your doctor helps with one problem or ten at the same visit, OHIP pays the same small amount. That’s why doctors often need to keep visits quick and focus on one concern per visit—so every problem gets proper time and attention and gets recognized by OHIP.