Attachment Bonus: Long Overdue, and We’re Watching Closely

Dear SGFP Members,

As the OMA has shared, the new patient attachment bonus codes for family physicians working in Patient Enrolments Models (PEMs) are now available in the OHIP billing system as of November 1. This is progress. But we should be clear about what it is: a payment you began earning on July 1, 2025, that is still not in your hands 16 months later.

Few issues have come up more often this year, in your emails, On-Call conversations, and our in-person engagements. Many of you have enrolled unattached patients in good faith since July 1, 2025, exactly as the system asked you to, and some of you are now owed thousands of dollars. You are frustrated, and you have every right to be. So are we.

What’s Happened

The attachment bonus was negotiated in the 2024–2028 Physician Services Agreement. The Ministry called it a top priority. Yet for more than a year, the only explanation we were given was that the codes needed to be programmed into the OHIP billing system. A top priority does not sit for 16 months. The SGFP pressed for action repeatedly, including a June letter to the bi-lateral Physician Services Committee (Ministry of Health and OMA) asking for a timeline and full retroactivity. The Ministry finally released its INFOBulletin on November 2.

Where Things Stand

You can now bill the bonus retroactively to July 1, 2025, and you’ll have seven months to complete that billing. That window helps, but your practices are still absorbing the cost of this delay. Many of you will be reaching back to July 2025 to identify eligible patients, confirm their paperwork, and match each one to a billable visit. That is unpaid work created by the delay, added to an administrative load that is already too heavy.

What You Can Do Now

The new patient attachment bonus applies to new patients without a family doctor who are new to you and your group, were enrolled on or after July 1, 2025, and who have signed both a  New Patient Declaration  and an Enrolment and Consent form. Locums are not eligible to bill the bonus.

• Review the OMA's patient attachment bonus page with tools, resources and answers to common questions.
• Confirm both signed forms are on file for each eligible patient.
• Bill the bonus alongside any in-person billable service provided in the usual family practice setting (i.e. not virtual) on or after July 1, 2025.

The OMA secured this flexibility, so you don’t have to backdate to each patient’s first visit.

In addition, there are now separate one-time fees available for attaching: 

• Health Care Connect patients who are complex/vulnerable  
• Select mother and newborn bonuses

• Visit the OMA’s Unattached Patient Fees page for full details on all unattached patient fees.

What We’re Watching: Declined Claims

Our biggest concern now is declines. You attached these patients in good faith, based on the information available at the time. Family physicians have seen how this plays out before. Claims are rejected after the fact, the reasons are unclear, and the physicians who do the right thing end up carrying the cost. That cannot happen here.

We are pushing for:

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• Clear, specific reasons for every declined claim
• No penalty for physicians who enrolled patients reasonably, and in good faith
• A fair and timely process to correct or appeal declines
• Transparency on how many claims are being declined, and why

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Thank you for continuing to take on unattached patients through all of this. You have held up your end, and we will work hard to make sure government holds up theirs.

Warm Regards,

Dr. Dave Barber, Chair, SGFP

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