{"id":1154,"date":"2026-10-17T19:32:53","date_gmt":"2026-10-17T23:32:53","guid":{"rendered":"https:\/\/publicpaypulse.com\/public-sector-insights\/?p=1154"},"modified":"2026-10-17T19:32:54","modified_gmt":"2026-10-17T23:32:54","slug":"ontario-doctor-pay-ohip-billing-sunshine-list","status":"publish","type":"post","link":"https:\/\/publicpaypulse.com\/public-sector-insights\/2026\/10\/17\/ontario-doctor-pay-ohip-billing-sunshine-list\/","title":{"rendered":"Ontario Doctor Pay: Salary, OHIP Billing, and Why Doctors Show Up Differently on the Sunshine List"},"content":{"rendered":"\n

Most Ontario physicians are not paid a salary at all<\/strong>. They bill OHIP as independent contractors \u2014 and the Sunshine List only discloses salary paid to an employee<\/strong>. That single distinction explains why a doctor with very high OHIP billings may never appear on the list, while a salaried doctor in a community health centre does.<\/p>\n\n\n\n

\"Doctor<\/figure>\n\n\n\n

The answer in 30 seconds<\/h2>\n\n\n\n

Doctors can<\/em> be on the Sunshine List \u2014 but only the minority who are employees<\/strong> of a hospital, university, community health centre, public health unit or another covered public-sector employer, and who were paid at least $100,000 in salary by that employer<\/strong> in the calendar year. The majority of Ontario doctors bill OHIP as independent contractors. OHIP billings are not salary, so they are not disclosed on the list at all.<\/p>\n\n\n\n

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\u201cPhysicians operate as independent service providers and are not government employees. Their services are billed to the Province under OHIP as established under the provincial Health Insurance Act<\/em>.\u201d<\/p>\n\n\n\n

\u2014 Legislative Assembly of Ontario, Standing Committee on Public Accounts, Physician Billing<\/em> (2017)<\/p>\n<\/blockquote>\n\n\n\n

Everything confusing about doctor pay in Ontario flows from that sentence. There are two different money systems<\/strong>, reported in two different places, for two different purposes \u2014 and readers routinely treat them as if they were the same number.<\/p>\n\n\n\n

In the OHIP system, the Ministry pays for an insured service and the money goes to the physician, group or corporation as gross practice revenue, out of which the practice pays rent, staff, equipment and insurance \u2014 plus the doctor’s own pension and benefits, because there is no employer providing them. In the employment system, a hospital, university or community health centre puts a physician on payroll, issues a T4, and \u2014 if that salary reaches $100,000 \u2014 reports it under the Public Sector Salary Disclosure Act, 1996<\/em> (the Sunshine List law). Same doctor, same province, completely different disclosure.<\/p>\n\n\n\n

How Ontario doctors are actually paid<\/h2>\n\n\n\n

There is no single \u201cdoctor salary\u201d in Ontario. Payment depends on specialty, setting and model \u2014 and the model determines both what the money has to cover and whether it is ever disclosed as salary.<\/p>\n\n\n\n

Fee-for-service: pay per service<\/h3>\n\n\n\n

Under fee-for-service (FFS), a physician is paid a standard fee for each insured service, using fee codes in OHIP’s Schedule of Benefits \u2014 a schedule the Ontario Medical Association describes as listing roughly 6,000 physician services<\/strong> and payment rules. The Legislative Assembly’s Public Accounts report describes FFS as the principal way physicians have billed since 1972 and as still widely used today, mainly by specialists.<\/p>\n\n\n\n

To bill OHIP at all, a physician needs a certificate of registration from the College of Physicians and Surgeons of Ontario and an OHIP billing number from the Ministry. Locum physicians must bill on their own<\/strong> billing number, not the number of a physician they are covering for.<\/p>\n\n\n\n

Family medicine: enrolment and capitation models<\/h3>\n\n\n\n

Most organized family practice in Ontario is not pure fee-for-service. Patients enrol (roster) with a practice, and payment blends a fixed per-patient amount with fee-for-service elements:<\/p>\n\n\n\n

Model<\/th>Who<\/th>Enrolment?<\/th>How it is funded<\/th><\/tr><\/thead>
Fee-for-service<\/td>Solo<\/td>No<\/td>Fee per service<\/td><\/tr>
Comprehensive Care Model (CCM)<\/td>Solo<\/td>Yes<\/td>Enhanced fee-for-service<\/td><\/tr>
Family Health Group (FHG)<\/td>Group of 3+<\/td>Yes<\/td>Enhanced FFS + enrolment fees, premiums, incentives and after-hours premium<\/td><\/tr>
Family Health Network (FHN)<\/td>Group of 3+<\/td>Yes<\/td>Blended capitation<\/td><\/tr>
Family Health Organization (FHO)<\/td>Group<\/td>Yes<\/td>Blended capitation<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

\nWhat \u201cblended capitation\u201d actually means in an FHO:<\/strong> a fixed capitation payment for each enrolled patient (adjusted by age and sex), plus<\/em> a fee-for-service \u201cshadow-billing\u201d premium for services inside the capitated basket, plus<\/em> full fee-for-service for services outside the basket, plus<\/em> fee-for-service for non-enrolled patients, incentives and bonuses, and an after-hours premium. The FHN works similarly, with a smaller capitated basket. In other words, even a \u201ccapitation doctor\u201d is still partly paid fee-for-service \u2014 the categories overlap.<\/p>\n\n\n\n

\nNew from 1 April 2026 \u2014 FHO+:<\/strong> Under the 2024 Physician Services Agreement, the modernized FHO (\u201cFHO+\u201d) raised the blended fee-for-service premium for in-basket services from 19.41% to 30%<\/strong> and the after-hours premium from 30% to 50%<\/strong>, ended the access bonus \/ outside-use deductions and comprehensive-care capitation payments, and added an Enhanced Group Management Leadership Payment of $4 per enrolled patient per fiscal year<\/strong> (max $100,000 per group). New hourly codes pay $80\/hour<\/strong> ($20 per 15 minutes) for direct, indirect and clinical-administration work, and $68\/hour<\/strong> ($17 per 15 minutes) for telephone care when not in the office \u2014 capped at 14 hours per day and 240 hours per 28-day cycle. (Sources: Ministry of Health INFOBulletins 260308 and 260309, 1 April 2026; OMA news release, 1 April 2026 \u2014 association framing.)<\/p>\n\n\n\n

Salary, sessional, hourly and Alternative Payment Plans<\/h3>\n\n\n\n