Fee schedule: Program of care (POC) for Mild Traumatic Brain Injury

Fees effective November 30, 2006

Block 1 - Education stream - for workers who are less than 3 months post date of injury
Service description Service code Minimum visits Fee
Initial Assessment and Initial Assessment Report MTBIAE 1 $70.00
Education - weeks 1-12 MTBIE 2 $90.00
Care and Outcomes Summary Report - whenever the worker is discharged MTBIC0S N/A $40.00
Block 2 - Active treatment & education stream - for workers who require active treatment and education who are more than 3 months and less than 1 year post date of injury
Service description Service code Minimum visits  Fee
Initial Assessment and Initial Assessment Report – only if worker did not enter Block 1  MTBIAT  1 $75.00
Cognitive Rehabilitation and Education – weeks 13-24,  MTBIC 6 $330.00
if required Manual Mobilization Therapy and Education – weeks 13-24,  MTBIM 5 $240.00
if required Care & Outcomes Summary Report – whenever the worker is discharged MTBICOS N/A $40.00
Block 1 & 2 - Education/Active treatment & education stream - for workers who require both education and active treatment who enter the program less than 3 months post date of injury
Service description Service code Minimum visits Fee
Initial Assessment and Initial Assessment Report MTBIAE 1 $70.00
Education – weeks 1-12  MTBIE 2 $90.00
Cognitive Rehabilitation – weeks 13-24,  MTBIC 6 $330.00
if, required Manual Mobilization Therapy – weeks 13-24, MTBIM 5 $240.00
Care & Outcomes Summary Report – whenever the worker is discharged  MTBIC0S N/A $40.00

Completion of Reports 

Initial Assessment Report 

  • Only 1 report is to be completed 
  • The report is to be completed prior to Block 1 OR Block 2 if the worker presents for the first time. 

Care & Outcomes Summary Report 

  • The report is to be completed when the worker is discharged from the POC 
  • Only 1 report is to be completed. 

Billing for Reports 

  • All reports are to be mailed or faxed within 2 days working days of assessment or discharge 
    • The completed RAND SF-36 Survey and the Rivermead Questionnaire do not have to be submitted to the WSIB. Ensure that you include the scores on the report. 
  • Billing Information section of the reports is to be completed in full for prompt payment 
  • Do not bill electronically for the payment of reports. 

Billing for treatment 

  • Minimum number of visits must be met 
  • Billing to occur at the end of treatment or whenever the worker is discharged 
  • Payment for the last block of service provided will be processed only when the Care & Summary Report is received and paid 
  • Enter the appropriate service dates (last treatment date), service codes, minimum number of visits (units) and corresponding fees 
  • Bill electronically through WSIB’s payment processor, Emergis Inc. 
  • Physicians continue to bill all insured services through the Ministry of Health and Long- Term Care (MOHLTC) according to the MOHLTC’s Physician’s Schedule of Benefits