For a year now OHIP has paid $63 for OCT.tests.Now billing explained in the Ontario Medical Review of Jan. 2012 p 25-27.
The Ontario Liberal Govt Minister of Health Dr.D.Matthews PhD(Sociology U.Western Ont) MPP London Cenral North blocked investors planning to set up an OCT clinic ($60-80,000 for one OCT) by refusing payment unless the test is performed by the patient's Primary Ophthalmologist or technician. According to the present Law, an Ontario resident cannot be billed for an Insured Service.
OCT (eg Carl Zeiss Ltd. "Cirrus") is paid for "medically necessary" conditions such as:
"Glaucoma monitoring" or if patient has Clinical Glaucoma, a Glaucoma Family History in the "immediate family".,or Ocular hypertension. Max 2 x year
Retinal disease or "Vision loss unexplained by dilated fundus exam." Max. 6 x year.
OPTOMETRISTS can bill patients directly: usually $75
OHIP does not pay for
Confocal Scanning Laser Ophthalmoscopy (cSLO)
Any physician or sSLO clinic can bill patients directly.
(eg Heidelberg Engineering Inc "HRT")
