​FSCO Clarifies Professional Services Guideline

Further to inquiries regarding how regulated and unregulated health care providers are paid for their services under the Professional Services Guideline (PSG), the Financial Services Commission of Ontario (FSCO) has offered the following clarifications; 

  • As specified in the PSG and in Bulletin A-02/04, unregulated providers and other regulated providers not listed in the PSG (e.g., social workers and physicians) are not covered by the PSG. The amount payable to service providers not covered by the PSG is to be determined by the parties involved.

  • Expenses for regulated and unregulated providers identified in the PSG are payable according to their professional designation and not by the services they provide. For example, case management services provided by an occupational therapist are payable at the occupational therapist rate and not at the case manager rate.

View Superintendant's Guideline A-03/18

Implications for Occupational Therapists

Occupational therapists who work in Ontario's auto insurance system are covered under the Professional Services Guideline which establishes maximum amounts payable by insurers for expenses related to the services of any of the health care professions and providers listed in the Guideline.  FSCO's clarification of the interpretation of the Guideline assures occupational therapists that the maximum amount payable for occupational therapists applies regardless of the focus of their work with claimants.