Canada Reimbursement for AI Echocardiography
Coding and reimbursement pathways in Canada for echocardiography across the provincial fee-for-service schedules: Ontario OHIP, British Columbia MSP, and Quebec RAMQ.
Reimbursement Landscape in Canada
Echocardiography is reimbursed under each province's public insurance schedule. The three largest by volume are Ontario (OHIP), British Columbia (MSP), and Quebec (RAMQ), each with its own item codes and tariff. Codes carry both professional and (where applicable) technical components.
Ontario (OHIP)
The Ontario Schedule of Benefits splits each echo study into a technical component and a professional component: G570 / G571 for the complete study, G574 / G575 for a focused study, G582 / G583 for stress echo, and G580 / G581 for TOE.
British Columbia (MSP)
BC Medical Services Plan uses item 08638 for echocardiography (real time) at $104.16 and item 08662 for exercise stress echocardiography at $239.76. Professional fees are paid to MSP-enrolled physicians; facility costs are funded separately under hospital global budgets.
Quebec (RAMQ)
Régie de l'assurance maladie du Québec uses code 08303 for the complete cardiac ultrasound study (M-mode + 2D + Doppler bundled). The Manuel des médecins spécialistes governs the schedule, with a daily cap of 30 exams beyond which the tariff falls to 1%.
Relevant Coding
Provincial item codes from the three largest provincial schedules. Other provinces (Alberta, Manitoba, Saskatchewan, Nova Scotia, New Brunswick) follow comparable fee-for-service structures with provincial code variants.
OHIP Complete Echocardiogram
Complete echocardiogram (1- and 2-dimensional). OHIP splits the study into a technical component (G570) and a professional component (G571), each billed separately.
Fees: G570 (technical) <strong>CAD $118.95</strong>; G571 (professional) <strong>CAD $96.20</strong>. The complete study includes Doppler analysis; the OHIP structure does not require a separate Doppler add-on. AI-assisted measurement and reporting supports the cardiologist or accredited sonographer's interpretation within G571.
OHIP Focused Study
Focused echocardiographic study for a specific clinical question (e.g. valvular follow-up, LV function in heart failure, pericardial assessment). Technical and professional components billed separately. Not to be claimed in conjunction with a pregnancy study.
Fees: G574 (technical) <strong>CAD $16.95</strong>; G575 (professional) <strong>CAD $13.95</strong>. Reported when a complete G570 / G571 study is not clinically required for the indication.
OHIP Stress Echocardiography
Stress echocardiography (exercise or pharmacologic). Technical and professional components billed separately.
Fees: G582 (technical) <strong>CAD $135.05</strong>; G583 (professional) <strong>CAD $110.15</strong>. AI-assisted strain and EF support pre- and peak-stress interpretation.
OHIP Transoesophageal Echo (TOE)
TOE: G580 covers the insertion of the oesophageal transducer; G581 covers the transoesophageal echocardiography professional component.
Fees: G580 (probe insertion) <strong>CAD $45.00</strong>; G581 (TOE professional) <strong>CAD $25.00</strong>. Typically billed by cardiologists or anaesthesiologists for valvular and intracardiac assessment.
BC Echocardiography (Real Time)
British Columbia Medical Services Plan code for echocardiography (real time). Doppler analysis is bundled into the single code.
Fee: <strong>CAD $104.16</strong> (April 2025 MSC Payment Schedule). Hospital technical costs sit outside the MSP schedule and are funded through provincial health authorities. Exercise stress echocardiography is billed as 08662 at <strong>CAD $239.76</strong>; contrast use carries a technical add-on of $125.00.
RAMQ Échocardiographie
Étude de la morphologie cardiaque et évaluation de la fonction ventriculaire par modalité M et bidimensionnelle, incluant l'analyse des flux intracardiaques par Doppler continu ou pulsé ou les deux.
Indicative fee: approximately <strong>CAD $70</strong> per procedure (per Quebec public-facing references; verify the current line item against the RAMQ Manuel des médecins spécialistes). Daily cap of 30 exams per physician, above which the tariff falls to 1%. The study is reduced to 75% of the tariff when performed on the same patient within 30 days by the same or another cardiologist.
Provincial schedules and fees are subject to negotiation between the Ministry of Health and the respective medical associations (OMA, BCMA, FMSQ). OHIP and BC MSP fees shown are as published; RAMQ amount is indicative and should be verified against the current Manuel des médecins spécialistes. Hospital technical components are typically covered under provincial global budgets where the technical OHIP code is not separately billed. Alternate payment plans (APP / AFP) at academic centres may pay echo studies through a different mechanism. Verify against the live provincial schedule.
Model the impact on your service
Enter your annual echo volume and the relevant provincial fee to estimate net new capacity from AI-assisted reporting.
Reimbursement by Care Setting
Echo studies in Canada are funded through provincial public insurance for the professional component, with hospital technical costs funded through global budgets and academic / hospital alternate-payment-plan arrangements.
Community Outpatient
Private cardiology and diagnostic-imaging clinics bill the provincial schedule for the professional fee. Facility costs are absorbed by the clinic operator.
Community outpatient echo is the highest-volume setting for AI-assisted reporting; throughput gains directly translate to billable volume.
Hospital Inpatient / Outpatient
Hospital-based echo studies bill the same provincial codes for the professional fee; the technical cost is covered by the hospital's global budget allocation.
Academic centres may run alternate payment plans (APP / AFP) where physician compensation is delinked from individual codes; AI value case here is throughput and length-of-stay.
Private / Workplace
Workers' compensation boards (WSIB / WorkSafeBC / CNESST) and self-pay studies use a parallel schedule. Most provincial private medical insurers follow CCSD-like adapted schedules.
Canadian Procurement & Regulatory Context
AI echocardiography software in Canadian hospitals and clinics is assessed against Health Canada licensing and PIPEDA / provincial health privacy laws.
Health Canada Licence
Software classified as a medical device requires a Medical Device Licence from Health Canada. Us2.ai holds a Class 2 Medical Device Licence and benefits from the MDSAP audit programme.
PIPEDA & Provincial Privacy
PIPEDA is the federal baseline; Ontario PHIPA, Alberta HIA, Quebec Law 25, and BC PIPA add provincial requirements. Canadian-region cloud hosting is supported, as is on-premise deployment where required.
CADTH & Hospital Procurement
CADTH Health Technology Reviews and provincial procurement frameworks (HealthPRO, Mohawk MedBuy, AccèsHA) are common procurement pathways. ISO 27001 + SOC 2 Type II certification support faster IT security review.
Frequently Asked Questions
Common questions about echocardiography coding and reimbursement in Canada.
Which provincial schedule should I bill against?
Why does OHIP split each echo study into two codes?
How is hospital echo paid in Canada?
Is there a Canada-specific code for AI echocardiography?
Is Us2.ai licensed by Health Canada?
How does data privacy work in Canada?
Are there volume controls on billing?
Does the MDSAP audit apply in Canada?
Where can I get Canada-specific reimbursement guidance?
Important Information
The information provided is for general informational purposes only and is not a guarantee of coverage or reimbursement. Provincial schedules of benefits, professional fees, and billing rules are subject to negotiation and change. Providers should verify against the current schedule published by their provincial Ministry of Health and applicable medical association (OMA, BCMA, FMSQ, AMA, etc.). This information does not constitute legal, financial, or billing advice.
Questions about Canada Reimbursement?
Our team can support business cases for community cardiology clinics, hospital cardiology services, and academic centres with current provincial schedule context, Health Canada documentation, and clinical evidence.
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