A landmark change is coming to Ontario’s healthcare system. Starting April 1, 2026, nurse practitioners (NPs) will finally be able to bill the Ontario Health Insurance Plan (OHIP) for the full scope of primary care services they provide. This follows a new federal interpretation of the Canada Health Act announced by Health Minister Mark Holland, confirming that “any medically necessary physician-equivalent services provided by regulated health professionals, such as nurse practitioners, are to be paid for by [provincial] health care plans.” In practical terms, NPs will have the same billing rights as doctors when delivering publicly funded care. From that date forward patients cannot be charged out of pocket for medically necessary NP services. Doing so would be illegal “extra billing” under the Canada Health Act.
Ontario’s NPs have long provided high quality primary care, but until now they have had to do so largely outside the OHIP billing framework. The Canada Health Act and OHIP traditionally only allowed physicians to bill for core medical services. Independent NPs in Ontario have thus been forced to rely on private pay models or limited special arrangements. For example, a 2024 Global News report described a Hamilton clinic where NPs charged $80 to $240 per visit because “nurse practitioners weren’t included in [OHIP], so… there’s no mechanism for us to be able to bill the government,” as the clinic director explained. Such clinics argued their fees were legal under the current rules , but advocates have long said charging patients for care that should be covered by medicare undermines the spirit of universal health care.
Federal policymakers agreed. In January 2025 Health Minister Mark Holland wrote to provincial health ministers with a new Canada Health Act policy. Effective April 1, 2026, any medically necessary service by an NP, or other regulated primary care provider such as a pharmacist or midwife, must be covered by the public plan just as if it were provided by a doctor. He noted that some patients were paying out of pocket at private NP clinics, which “isn’t consistent with universal health care,” and that the new interpretation “shuts that down”. From 2026 onward provinces must ensure NPs can submit OHIP claims for primary care, or risk losing federal health transfer funds to penalties.
These policy changes follow years of advocacy by Ontario’s nursing community. The Registered Nurses’ Association of Ontario (RNAO) and the Nurse Practitioners’ Association of Ontario (NPAO) have long called for NPs to be fully integrated into the public system. In 2024 Ontario’s Health Minister Sylvia Jones even wrote to Ottawa urging action. RNAO President Lhamo Dolkar summed it up: “Premier Doug Ford, the time to act is now. Ontario must urgently implement a funding model to support NPs… without charging [patients]”. In response, Minister Holland stated clearly that any “medically necessary physician-equivalent services… provided by regulated health professionals, such as nurse practitioners, are to be paid” by public plans.
For Ontario NPs, the April 2026 change means greater access and equity. Key points include:
For patients, this means no more surprise charges at the clinic for routine NP care. Services like chronic disease follow ups, prescribing birth control, vaccinations, or treating infections, tasks NPs already perform, will all be covered by OHIP when medically necessary. As Health Canada put it, “Canadians have equitable access to medically necessary care based on their medical needs, not their ability to pay”.
GoodX Healthcare has long been a partner for Ontario’s NPs, providing integrated practice management and billing software. Today, GoodX helps NPs with all aspects of their clinic, from secure charting to scheduling to patient portals. Crucially, GoodX already makes private billing simple. NPs using GoodX can bill confidently with full support for private and insurance billing. The system supports multiple fee schedules and insurance plans, automated claim submission, and even online payments. Until now the OHIP claims feature has been used primarily by physicians, but it is fully available in the platform.
As Ontario transitions to OHIP billing for NPs, GoodX will be ready. Starting April 2026, any Ontario NP using GoodX will be able to submit OHIP claims through the same system they already use for everything else. This means no extra paperwork or new software. GoodX will simply integrate the new billing codes and submission processes for NPs. In short, GoodX streamlines the entire billing workflow so NPs can focus on patient care instead of paperwork.
GoodX is also preparing educational resources to help NPs master OHIP billing. We are developing a short training course specifically for Ontario NPs that will explain how OHIP billing works and how to use GoodX to handle it. In the meantime, NPs can get a head start on the general billing process with GoodX’s free online training. For example, GoodX offers a Click-and-Learn course called “Workflows for Billing Experts in the Canadian Healthcare Practice,” which walks users through typical billing workflows in a virtual practice. This course is available at no cost on GoodX’s Courses site. It covers essentials like creating patient accounts, coding visits, and submitting claims, valuable knowledge for any provider about to join the OHIP system.
Even today, GoodX empowers NP practices with features like:
With GoodX managing both practice operations and billing, Ontario NPs will be well positioned to adapt to the new OHIP rules. All the features that make GoodX valuable today, including billing automation, user friendly interfaces, and training support, will ease the transition.
Ontario nurse practitioners can already prepare for the 2026 change. Here are some key steps:
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Ontario’s move to allow NPs to bill OHIP is a historic step toward expanding access to care. It reflects the reality that NPs are primary care providers who should be funded like physicians. From April 2026 onward, Ontarians will be able to see NPs without facing direct charges for insured services. GoodX Healthcare is proud to support NPs through this transition. We already help nurse practitioner clinics manage private billing and streamline practice workflows, and soon we will add OHIP billing for Ontario NPs into our platform.
By staying informed and leveraging GoodX’s tools and training, Ontario’s nurse practitioners can be fully prepared. This change will bring thousands more Ontarians into care, and GoodX will continue to be the system that makes it easy, for providers and patients alike.
