Earlier this month, FSCO released its annual update to the Professional Services Guideline as well as the Pre-approved Framework (PAF) Guideline for Grade I and II Whiplash Associated Disorders (WAD). These guidelines establish the maximum fees that auto insurance companies can record for particular rehabilitative treatments and PAF interventions.
As usual, the fees have increased since last year in order to match inflation. This year, both the Professional Services Guideline’s maximum hourly fees and the WAD fees have increased by 2.3%. This keeps in line with FSCO’s trend of increasing maximum fees by about 2% each year since 2006.
The increased fees come into effect on August 1, 2009. This means that the new Professional Services Guidelines apply to all services rendered on or after August 1, and that the new PAF Guidelines apply to all OCF-23’s submitted on or after August 1.
The following charts summarize the major changes in fees for both Guidelines. We encourage you to access the full documents online at www.fsco.gov.on.ca.
Revised Healthcare Provider Rates
| HEALTHCARE PROVIDER | MAXIMUM HOURLY RATE (EXCEPT CATASTROPHIC IMPAIRMENTS) | MAXIMUM HOURLY RATE (CATASTROPHIC IMPAIRMENTS) |
|---|---|---|
| Chiropractors | $ 106.41 | $ 127.69 |
| Massage Therapists | $ 54.89 | $ 84.02 |
| Occupational Therapists | $ 94.09 | $ 113.12 |
| Physiotherapists | $ 94.09 | $ 113.12 |
| Psychologists and Psychological Associates | $ 141.13 | $ 169.12 |
Revised PAF is up to $ 1438.65
| REGULAR PAF INTERVENTIONS | FEE |
|---|---|
| Initial visit (1 session) | $ 213.29 |
| Acute phase (up to 10 sessions) | $ 519.11 |
| Sub-acute phase (up to 9 sessions) | $ 444.68 |
| Completion of OCF-24 (payable once at discharge) | $ 87.19 |
| Supplementary Goods and Services | $ 174.38 |
