April 16, 2023

OHIP Schedule of Benefits

ohip schedule of benefits

The ohip schedule of benefits (often referred to as the SOB) is a list of all OHIP insured medical services, including drugs, office visits, procedures and imaging. The SOB is a great reference point to help you understand what your insurance plan covers and what you’re responsible for out-of-pocket.

OHIP frequently releases bulletins with changes and updates to the SOB, so it’s important to keep an eye out for these. You can also make sure you’re using an OHIP billing software that automatically updates the SOB, so you’ll always be using the latest codes and premiums.

The SOB is a 960 page PDF that lists around 6,000 services, covering every specialty and includes premiums, rules and descriptions. It can be time consuming and tedious to search through the entire SOB, which is why we recommend book marking the OHIP online SOB searchable database so you can quickly find the codes and information that matter most to you.

In the medical world, technology and knowledge are constantly changing. This is why the OHIP schedule of benefits was redesigned to include new and improved fee codes, a higher deductible, and better patient-centered service design features.

OHIP’s new Appropriateness Working Group has also been working to improve the SOB by suggesting changes that will lower wait times and reduce healthcare costs. This is the most recent iteration of the OHIP schedule of benefits, which was first introduced in 2008. Its main purpose is to identify the most appropriate and effective health care services for Ontario’s population.


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