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Paramedical services | 2025 reasonable and customary fees

News Release

Consistent with industry standards and practices, we regularly review and adjust the reasonable and customary fee limits to ensure that all allowable amounts are representative of industry standard fees.

Where fees are not representative, we change them. The new reasonable and customary fees will take effect on January 1, 2025.

What are reasonable and customary fees?

The cost of a paramedical service varies between specialists. Reasonable and customary fees correspond to the maximum acceptable amounts established for certain services based on their average cost in any given region.

What are the impacts of reasonable and customary fees on claims?

A limit applies to a claim for a paramedical service if the provider charges more than the reasonable and customary fee. The plan member must pay the difference. Limits are also subject to any deductibles and reimbursement percentages specified in the group plan.

Where to find the updated list of reasonable and customary fees?

It will be available in My Client Space, under Guides and Resources, in the left-hand menu, as of January 2025.

For further information regarding your coverage with respect to reasonable and customary fees for paramedical services, please refer to your group insurance booklet in My Client Space under Forms and Documents in the left-hand menu.