Does Virtual Care Count Toward Ontario ROS?

The virtual care paragraph in the current program guidelines reads:

“The ministry recognizes the importance of virtual care and telemedicine services as integral components of clinical care delivery, helping to bridge the gap by connecting patients in rural and remote areas with specialists or primary care providers […]. Up to 40% of the virtual care services / telemedicine services can be counted as ROS commitment.”

One phrase changed between editions

The earlier October 2025 file said “A minimum of 40%.” The revised file, posted at a December 2025 URL and still dated October 2025 on its face, says “Up to 40%.” We compared the two editions word by word and this is the only difference. Advice based on the older wording reads the rule as a floor when it is now a ceiling.

What the two ministry sources say

Question	Guidelines	Ministry page
Percentage	“Up to 40%”	None given
Payment basis	“OHIP-covered”	“publicly funded”
Approval	Not mentioned	“with prior approval”
Location wording	“connecting patients in rural and remote areas”	“provided in an eligible community” and “delivered to an eligible community”

The ministry page uses both “provided in” and “delivered to,” so it does not settle whether the physician or the patient has to be in the eligible community. A separate rule covers patients who live in eligible communities, and the sources do not say how that rule combines with this one.

OHIP rules that apply to any virtual visit

Rule	Source wording
Location	“Both the patient and physician must be located in Ontario for the services to be insured and payable under OHIP”
Video	Must use “a Verified Video Solution, as defined by Ontario Health”
Comprehensive care	Requires an “Existing/Ongoing Patient-Physician Relationship”
Limited care	Applies where no such relationship exists
Enrolled patients	Excepted from the 24-month in-person renewal when enrolled to the family physician’s primary care practice

Those rules come from the ministry and OMA billing briefs on comprehensive and limited services and terms and conditions.

What the fee schedule pays

Fee differences matter because hours are only part of the calculation. A virtual-heavy plan has to work as income as well.

Service type	Payment in the Schedule of Benefits
Comprehensive, video	Equivalent to the corresponding in-person fee
Comprehensive, telephone	85% of the in-person fee (95% for K007, K005, K197 and K198)
Limited, video (A101)	$20.00
Limited, telephone (A102)	$15.00

OHIP pays a flat fee for a limited service to a patient with no existing relationship, so a virtual practice built on unattached patients in eligible communities earns differently from one serving your own enrolled patients.

What to ask the ministry

What is the 40% measured against?
Does prior approval still apply to agreements under the 2026 terms?
Must the physician, the patient or both be in an eligible community?
Do virtual hours fall inside the 50% patient catchment figure, or sit alongside it?

Confirm how this applies to your agreement with the Ministry of Health.

Common questions

Is it 40% of my 7,200 hours?

The sentence says 40% of "the virtual care services," not 40% of 7,200 hours. If the ministry meant the total, that would be 2,880 hours, but the guidelines do not say so. Confirm it in writing.

Do I need ministry approval for virtual hours to count?

The ministry page still says telemedicine counts "at the discretion of the ministry and with prior approval." The guidelines do not repeat that condition, and no source says whether it still applies under the 2026 terms.

Are OHIP virtual visits paid the same as in-person visits?

Comprehensive video services pay the corresponding in-person fee. Comprehensive telephone services generally pay 85%, or 95% for four codes. Limited virtual care pays $20 by video and $15 by telephone.

Sources

The offer

Family physician, Bay and College, Toronto.

Compensation

Fee-for-service Family Health Group (FHG), applying for FHO+ next year.

Overhead: 0% for your first one and a half OHIP billing cycles. Then 20% of your OHIP billings (plus HST) at four or more clinical days a week or $30,000 a month in billings. Below that, 25%.

Estimated earnings: $32,000 to $43,000 a month in billings. $25,000 to $35,000 a month after overhead, from OHIP and private fees.

Attachment bonus: OHIP pays you $100 to $120 for each patient you attach who has no family doctor.

Profit share: Builds by about $3,200 a month, up to $38,000 a year, scaled to days worked. Paid by the clinic in June and December, no overhead. Can go toward your annual HOOPP pension contribution.

Paid leave: six weeks a year, building from your first day. A locum sees your patients while you’re away, so nothing piles up.

Professional allowance: up to $5,000 a year for CME, dues and licensing.

Gym membership: paid by the clinic.

Return of Service Repayment Calculator (Ontario 2026)

About this research

Button Health researched these rules directly from ministry, regulator and other primary sources, and links each one so you can read it yourself. Button Health is a family practice at Bay and College in Toronto that recruits family physicians, so we have an interest in this topic.

This page is general information, not legal or financial advice. Rules change, and your agreement is what binds you.

Does virtual care count toward return of service in Ontario?