| Roster name | Service code | Fee |
|---|---|---|
| Dermatology | M662 | $214.01 |
| General surgery | M665 | $214.01 |
| Physical medicine & rehabilitation | M673 | $214.01 |
| Neurology / Neurosurgery | M668 | $214.01 |
| Respirology | M676 | $214.01 |
| Allergy / Immunology | M679 | $214.01 |
| Internal medicine | M667 | $214.01 |
| Chronic pain disability | M680 | $214.01 |
|
Psychiarty |
M675 | $214.01 |
| Ophthalmology, vision | M671 | $214.01 |
| Otolaryngology (E.N.T.), hearing | M672 | $214.01 |
| Urology | M677 | $214.01 |
| Peripheral vascular | M661 | $214.01 |
| Plastic surgery - disfigurement | M674 | $214.01 |
| Plastic surgery - complex hands | M681 | $214.01 |
Note: The WSIB reserves the right to remove the physician’s name from the roster where the physician is consistently unable to provide timely assessments and reports.
| Body area | Service code | Fee |
|---|---|---|
| Upper extremity | M745 | $214.01 |
| Lower extremity | M746 | $214.01 |
| Cervical spine | M747 | $214.01 |
| Dorso-lumbar spine and pelvis | M748 | $214.01 |
Note: For assessments involving more than one of the above areas, the fee is still $214.01
| Service included | Service code | Fee | Maximum Fee |
|---|---|---|---|
| Assessments exceeding one hour | M743 | add $53.50 (for every 15 minutes or major part thereof) | $214.01 for 60 minutes |
Maximum allowable billing: $428.02
Note: These fees include the assessment and the time spent reviewing documents and report preparation.