OHIP & Physiotherapy

OHIP funded physiotherapy is delivered in communities by Designated Physiotherapy Clinics (DPCs). By government policy, the number of Designated Physiotherapy licenses (previously Schedule Five Physiotherapy licenses) has been frozen since 1964. Currently there are about 91 licenses authorized to bill OHIP for both clinic based and home based services and 29 licenses authorized to bill OHIP for home based care alone. The policy not to issue additional licenses since 1964 has meant that the system has not grown to meet increased demand or changes in geographic distribution of the population. For instance, there are currently no OHIP-covered physiotherapy clinics in Mississauga.

OHIP covers physiotherapy treatment for a fee of $12.20 per visit in a clinic and $24.40 for an initial home visit. OHIP does not cover the cost of assessment or re-assessment, so in many instances an additional assessment and/or administrative fee is charged to the patient.

In 2004, the government announced it would delist physiotherapy services from OHIP effective March 31st, 2005. In late March 2005, the government announced that the delisting would be limited to those between the ages of 18 and 64 who are not receiving benefits under the Ontario Disability Support Program, Ontario Works and Family Benefits. These changes came into effect April 1st, 2005.

This means that, in order to be covered for physiotherapy services at a Designated Physiotherapy Clinic, you must have a doctor's referral and:

• Be 19 years old or younger, or;
• Be 65 years old or older, or;
• Are receiving benefits under the Ontario Disability Support Program or Family Works, or;
• Have been overnight in hospital for a condition that now requires physiotherapy treatment.

In addition to clinic and home visits, many Long Term Care homes receive services from DPCs. In 2005, in response to the government's commitment to ensure that those over 65 and those who live in Long Term Care homes have access to physiotherapy services, government and stakeholders have been working together to expand services to those homes that had little or no access to physiotherapy under the previous (OHIP Schedule 5) system. In a phased approach, services are now being contracted with individual physiotherapists, private clinics, hospitals and DPCs to achieve this goal.

If you would like further information on whether you qualify for OHIP physiotherapy services, or for help locating a DPC near you, contact us at physiomail@opa.on.ca or call (416) 322-6866.

• April 1st, 2005
  Important Announcement regarding the changes to Physiotherapy Services effective April 1, 2005
• March 23rd, 2005
  OPA responds to Ministry Announcement on OHIP-Funded Physiotherapy