One visit, two bills. The insured service goes to the ministry as an ordinary OHIP claim designated under the WCB payment program — same codes, same electronic channel. The forms and reports go to WSIB and are paid from WSIB's own fee schedule: $65.00 for a paper Form 8, $85.00 for the same form submitted electronically. Most of the money physicians leave on the table here is the second bill.
IntelAGENT sets the WCB claim type on the claim and reports work-related billings separately from the rest of your practice. See how →
Fees and rules change, and this page is not the authority. WSIB publishes the current physician amounts on its physician fee schedule, which was last updated 23 January 2026, and the billing direction on its physician billings page. Check both before relying on an amount.
The split
| What you did | Who you bill | How |
|---|---|---|
| The assessment, consultation or procedure | Ministry of Health | OHIP Schedule of Benefits code, under the WCB payment program |
| Form 8 after the first visit | WSIB | WSIB fee schedule, code 8M or 8ME |
| Progress report when WSIB asks for one | WSIB | WSIB fee schedule, code 26M or 26ME |
| Consultation or operative report | WSIB | WSIB fee schedule, codes M647, M644 |
| Reviewing records, answering WSIB's questions | WSIB | WSIB fee schedule, per report or per 15-minute unit |
The first row is the one that surprises people: the clinical service is not billed to WSIB. WSIB's own instruction is to bill the ministry using the OHIP Schedule of Benefits and the WCB payment program. So the claim travels the same electronic path as every other OHIP claim you submit — it is simply designated as a work-related claim rather than an ordinary insured service.
The practical implication for your billing setup is small but real: the designation has to be set on the claim. Set wrongly, the claim is still an OHIP claim and will usually still pay, so nothing fails loudly. What goes wrong is downstream, in reconciliation and in any analysis that assumes every claim is an ordinary insured service.
The reports, and what they pay
These are the amounts on WSIB's published physician fee schedule as of its 23 January 2026 update. Read them as a guide to the shape rather than as gospel — the schedule is the authority and it changes.
| Code | Report | Fee |
|---|---|---|
| M649 | Complex report | $112.10 |
| 8ME | Health Professional's Report (Form 8) — electronic | $85.00 |
| CMS8 | Occupational mental stress report — paper | $85.00 |
| 8M | Health Professional's Report (Form 8) — paper | $65.00 |
| 26ME | Progress report (Form 26) — electronic | $60.00 |
| M651 | Review of medical records or literature, per 15-minute unit | $56.05 |
| M647 | Consultation report | $47.09 |
| M641 | Hospital emergency department consultation report | $47.09 |
| 26M | Progress report (Form 26) — paper | $45.00 |
| FAF | Functional abilities form | $45.00 |
| M645 | In-office interview with a WSIB representative | $29.15 |
| M644 | Operative report | $23.54 |
Amounts are WSIB's, not ours. The full schedule includes cannabis and opioid assessment forms, drug utilisation reports, occupational disease and chest disease reports, home oxygen therapy, orthotic reports and acupuncture. See WSIB's physician fee schedule.
Submit electronically where the form offers it. The same report pays $85.00 electronically and $65.00 on paper; a progress report pays $60.00 against $45.00. That is a 31% and 33% difference for the identical clinical work, and it is the easiest uplift in this entire guide.
Form 8 rules worth knowing
- One per worker. WSIB's schedule says to complete and submit a Form 8 following the initial visit where a worker has been treated for a workplace injury or illness, and to submit only one Form 8 for each worker.
- It is not a progress report. The schedule states this explicitly. Progress goes on a Form 26 or a narrative report, and a Form 8 reused as a progress report is the wrong document.
- Recurrences. The schedule notes a Form 8 can also be completed when the worker reports a recurrence of a previous work-related injury or illness.
- Occupational mental stress has its own form. A Form CMS8 rather than a Form 8, also one per worker, also not a progress report.
- Form 26 comes to you via the worker. WSIB sends the progress report form to the worker; you complete it when the worker brings it. A previously completed Form 26 must not be altered or reused as a new report.
When the patient does not want it reported
This happens, and it is worth knowing the position before you are standing in it. WSIB's physician billings page cites OMA guidance that where a patient asks that the injury not be reported, the physician should respect that request and not report it to WSIB — and should also refuse to bill the medical service to OHIP.
In other words it is not a choice between the two payers. If the work-relatedness is not being reported, the service is not an ordinary OHIP claim either. That is a question to resolve with the patient at the time rather than at billing.
Getting paid, and the deadline
Two separate payment streams, which means two separate things to reconcile:
- The OHIP side behaves exactly like the rest of your billing. Same submission, same error reports, same monthly remittance advice. See reading a Remittance Advice.
- The WSIB side does not. WSIB pays for forms and reports, and for calls it initiated, without a separate bill from you in the ordinary case; where a bill is needed it goes on WSIB's own Provider Payment Request form, which requires your WSIB provider ID and the worker's claim number. There is no remittance advice to reconcile it against the way there is on the OHIP side.
WSIB's fee schedule also contains a late accounts provision reducing accounts submitted long after the date of service. The specifics are in the schedule; the practical rule is the same as everywhere else in billing — submit as the work happens, not in a quarterly catch-up. Deadlines and stale dating makes the same argument for the OHIP side.
WSIB runs a Health Professional Access Line on 416-344-4526, or 1-800-569-7919 toll free, for billing and reporting questions.
Work injuries billed to the right payer
A work injury splits across two payers with two sets of rules. Getting the split wrong is the usual reason WSIB work is underpaid.
- WSIB claims submitted as WCB claim types. The claim type is set on the claim, so the clinical service bills to the ministry under the WCB payment program rather than as an ordinary insured service.
- Work-related claims separated in reporting. They are distinguishable from ordinary OHIP claims in revenue summaries, which is what makes a reconciliation meaningful.
- The OHIP half is just billing. Same submission, rejection handling and remittance reconciliation as everything else.
The WSIB reports themselves are submitted to WSIB, not through OHIP, so they are not something a billing system sends for you. Knowing they are billable is the part that is worth money.
Three months free, then 0.25% of paid claims, capped at $39.99 a month. IntelAGENT has submitted OHIP claims since 2016 for more than 2,000 Ontario physicians.
Frequently asked questions
Do I bill OHIP or WSIB for a work-related injury?
Both, for different things. WSIB directs physicians to bill the ministry for the insured service using the OHIP Schedule of Benefits under the WCB payment program. The forms and reports — the Form 8, a progress report, a consultation report — are billed to WSIB on its own fee schedule.
What is the WCB payment program?
It is the OHIP payment program used for services relating to a work-related injury or illness. The claim goes through the normal electronic channel as an OHIP claim, but it is designated WCB rather than being billed as an ordinary insured service.
What is a WSIB Form 8 worth?
WSIB's physician fee schedule lists the Health Professional's Report at $65.00 submitted on paper and $85.00 submitted electronically. Submit only one Form 8 per worker — it is the initial report and must not be used as a progress report.
Does electronic submission pay more for WSIB forms?
Yes, on the forms that have both options. The Health Professional's Report is $65.00 on paper and $85.00 electronically, and the progress report is $45.00 on paper and $60.00 electronically, according to WSIB's published physician fee schedule.
Sources
- WSIB — Fee schedule: Physician — report codes and amounts, updated 23 January 2026.
- WSIB — Physician billings: WCB payment program — the direction to bill the ministry under the WCB payment program, and the OMA guidance on unreported injuries.
- WSIB physician fee schedule (PDF) — report descriptions, Form 8 rules, and the Provider Payment Request form.
- OHIP Schedule of Benefits and Fees — the codes used for the insured service.
Related reading
Reading a Remittance Advice
How the OHIP half of a work-related claim comes back.
GuideBilling deadlines
Late accounts get reduced on both sides.
GuideReduce missed billings
Unbilled WSIB reports are a category of this.
ProductDepartments and groups
Work-related billings reported separately from the rest.