Ontario Physician Fee Increases Effective April 1, 2026
Ontario physicians are seeing payment increases effective April 1, 2026.
Under Year 3 of the 2024 to 2028 Physician Services Agreement, the Ministry of Health states that physician fee for service payments and automated payments in the Medical Claims Payment System, including capitation, premiums, and salaries, will receive a relativity-adjusted increase for services provided between April 1, 2026 and March 31, 2027. The overall compounded increase is 5.3700 percent, but the actual rate applied depends on specialty and funding model.
This matters because many physicians will hear that payments are increasing by 5.37 percent and assume that applies equally to everyone. It does not. The Ministry is applying relativity-adjusted increases by specialty and by model, and for family medicine the rate is different depending on whether the physician is in a capitation model such as FHO or a fee-for-service style model such as FHG, CCM, or straight FFS.
What changed on April 1, 2026
Effective April 1, 2026, Ontario began applying the new Year 3 relativity-adjusted increase to physician fee for service payments and automated payments in the Medical Claims Payment System. The Ministry states that this 2026 to 2027 increase replaces the prior relativity-adjusted increase that ended on March 31, 2026. Relativity-adjusted payments will begin appearing on the May 2026 Remittance Advice.
The Ministry also states that fee for service payments and adjustments to automated payments related to fiscal year 2025 to 2026, even if paid after April 1, 2026, will continue to be paid using the previous relativity rates in effect for 2025 to 2026. That means physicians should expect some transition complexity when reviewing spring Remittance Advices.
This is broader than just FHO
This change affects more than capitation-based family medicine.
Ontario’s April 1, 2026 bulletin applies the relativity-adjusted increases to fee for service payments and to automated payments such as capitation, premiums, and salaries. For primary care, the published tables include Family Health Group, Comprehensive Care Model, Fee For Service family practice, Family Health Organization, Family Health Network, Group Health Centre, Blended Salary Model, Community Health Centre, NP-led clinic collaboration models, and several other arrangements.
For family medicine specifically, the Ministry lists the following 2026 to 2027 relativity rates:
| Family medicine category | 2026 to 2027 relativity-adjusted increase |
|---|---|
| Family Health Group, Comprehensive Care Model, Fee For Service family practice | 6.2901% |
| Family Health Organization, Family Health Network, Group Health Centre | 4.8506% |
| Overall compounded PSA increase | 5.3700% |
These are the published Ministry rates for the categories above.
What this means for FFS, FHG, CCM, and FHO physicians
For physicians working in FFS, FHG, or CCM style models, the Ministry’s published family medicine rate is 6.2901 percent for 2026 to 2027. For physicians in FHO, FHN, or GHC capitation models, the published family medicine rate is 4.8506 percent.
That does not mean every line on every RA will move in a simple one-for-one way. The Ministry is clear that the increase is being applied through fee for service payments and automated payment streams, and that these are relativity-adjusted payment increases rather than a simple across-the-board code fee change.
Important point about fee codes
This is where many physicians can get confused.
The Ministry states that the value of Fee Schedule Codes listed in the Schedule of Benefits has not changed in relation to the relativity increases. It specifically directs physicians to a separate bulletin for Year 3 schedule adjustments and notes that the relativity-adjusted increase is not the same thing as simply changing the listed Schedule value for every code.
Because of that, using a code-by-code example such as “A007 before April 1 versus after April 1” can be misleading unless you are specifically tying it to the updated fee schedule mechanism and payment methodology for that code. For a broad physician communication, the cleaner and more accurate approach is to show the impact at the billing-model level rather than imply that every common office code increased in a uniform, standalone way.
Simple examples of what the increase could mean
For physicians in FFS, FHG, or CCM models, using the Ministry’s published 6.2901 percent family medicine rate, the increase can be illustrated like this:
| Annual gross OHIP billings | Approximate increase at 6.2901% |
|---|---|
| $200,000 | $12,580 |
| $300,000 | $18,870 |
| $400,000 | $25,160 |
| $500,000 | $31,450 |
For physicians in FHO, FHN, or GHC models, using the Ministry’s published 4.8506 percent family medicine rate:
| Annual payments / billings base | Approximate increase at 4.8506% |
|---|---|
| $200,000 | $9,701 |
| $300,000 | $14,552 |
| $400,000 | $19,402 |
| $500,000 | $24,253 |
These are simple percentage illustrations based on the Ministry’s published rates. Actual impact will vary depending on payment stream, model, billing mix, premiums, capitation composition, shadow billing, and service period.
Why some physicians will see different impacts even within family medicine
Not every physician will experience the increase in exactly the same way.
A physician in an FHG with a high volume of fee for service billing may feel the increase differently from an FHO physician whose income mix is more heavily driven by capitation and automated payments. A physician with stronger billing processes may also notice a more meaningful difference because the increase is being applied to a cleaner, more complete revenue base. The Ministry’s own tables show that the applicable percentage is model-dependent, and its bulletin makes clear that both fee for service and automated payments are involved.
The Ministry also notes that derived specialty for fiscal year 2026 to 2027 is assigned based on physician billings for fiscal year 2025 to 2026. Physicians without claims in 2025 to 2026 will initially be assigned the 5.3700 percent global rate until sufficient claims are submitted in 2026 to 2027 to determine an accurate derived specialty.
What physicians should watch for on their Remittance Advice
This year, it is worth reviewing your RA more carefully than usual.
Key things to watch for:
- whether your model category matches what you expect
- whether the relativity-adjusted payment appears in the correct period
- whether payments relate to 2025 to 2026 service periods or 2026 to 2027 service periods
- whether your family medicine category is being treated as FHO/FHN/GHC or FHG/CCM/FFS
- whether any billing issues are masking the real benefit of the increase
The Ministry states that relativity-adjusted payments will begin appearing on the May 2026 RA and that prior-year payments made after April 1, 2026 may still be paid at the previous year’s relativity rate.
Why billing support matters even more with these changes
A payment increase is only as useful as the billing system around it.
If a physician is underbilling, missing premiums, not reconciling rejections, or not understanding how different payment streams are flowing through the claims system, part of the benefit can be lost or misunderstood. That is one reason these 2026 changes matter beyond just the published percentages. When the increase is being applied through multiple payment mechanisms, careful billing review becomes more important, not less. The Ministry’s bulletin makes clear that this year’s changes touch fee for service payments, capitation, premiums, salaries, and other automated payment streams.
For many physicians, especially in blended or capitation models, strong billing oversight is what turns a posted increase into a real-world revenue improvement.
A note on appeals
The Ministry states that there is no appeal process for physicians disputing the amount of the relativity-adjusted increase they received, because the methodology was agreed to between the Ministry and the OMA in accordance with the Physician Services Agreement.
That does not mean physicians should ignore anything that looks off. It means the first step is to verify the billing period, payment category, funding model, and specialty assignment rather than assume there is a formal appeal route for the relativity methodology itself.
Bottom line
As of April 1, 2026, Ontario physician payments increased more broadly than just FHO arrangements.
The Ministry’s published family medicine rates show 6.2901 percent for FHG, CCM, and Fee For Service family practice, and 4.8506 percent for FHO, FHN, and GHC, within an overall Year 3 compounded PSA increase of 5.3700 percent. These increases affect both fee for service billings and automated payments in the Medical Claims Payment System, but they do not translate into a simple uniform increase to every individual fee code.
For physicians, the most practical takeaway is to understand your model, review your RA carefully, and make sure your billing support is strong enough to confirm how these changes are actually flowing through your payments.