Updated: January 2020
Both the Tuberculosis Skin Test (TST) and Interferon Gamma Release Assay Quantiferon (IGRA-QFT) are acceptable tests for Tuberculosis Infection diagnosis. More information can be found within the Canadian TB Standards 2022, Diagnosis of TB Infection.
TST and Billing
Tuberculosis Skin Test (TST)
The TST determines if someone has developed a cell-mediated immune response to the Tuberculosis (TB) bacterium – it does not detect the presence of TB bacteria directly. This immune response occurs if someone has been exposed to TB in the past.
More information
TB Infection – Diagnosis, Treatment and Reporting
Billing: Ontario Health Insurance Program (OHIP) insured
Only the appropriate OHIP fees can be claimed. (e.g., A001 or A007 for the visit/assessment, G372 for the injection, or G373 sole reason for the visit).
TB skin tests and documentation are covered under the Ontario Health Insurance Plan (OHIP) and cannot be billed to patients, for the following scenarios:
- people who are identified by public health as contacts of a TB case.
- people who require evidence of a completed TB skin test for admission or continuation in a daycare or pre-school program or a school, community college, university or other educational institution or program (including a work placement that the program may require) or for admission into a Long Term Care Facility
- people who require TB testing for a medically necessary purpose e.g. chemo or biologic agent
- people who have a high risk of TB reactivation such as newcomers who are from a TB endemic country and have been in Canada for less than two years
A TB skin test is covered by OHIP if a physician determines that the TB skin test is medically necessary. However, the documentation for the test is not covered.
The TB skin test is covered in the following scenarios.
- The receipt of disability or sickness benefits or the satisfaction of a condition relating to the disability or sickness benefits
- Return to a day care of pre-school program, after a temporary absence
- A condition relating to the fitness to continue employment other than a condition that requires an examination or assessment to be conducted on an annual or other periodic basis
- An absence from or return to work
- Legal proceedings
TB skin test and documentation is not covered under OHIP for the following scenarios:
- Employment and volunteering purposes
- Travel purposes
Government provided tubersol (TST solution) for uninsured TB testing
Please note that tubersol provided by the government is not to be used for uninsured TB testing. When uninsured testing is performed, tubersol should be either:
- acquired by the physician or sold to the patient at a direct cost with reasonable mark-up or
- acquired by the patient from the pharmacy, via prescription provided by the physician.
Resources
Interferon Gamma Release Assay-Quantiferon (IGRA-QFT) and Billing
The IGRA blood test screens for exposure to Tuberculosis (TB) by indirectly measuring the body’s immune response to antigens derived from the TB bacteria. The IGRA-QFT test can differentiate a Bacille Calmette-Guerin (BCG) response from a TB exposure-response. IGRA is preferred in people who have received one or more BCG vaccines after the age of one year. Visit the Canadian TB Standards, 2022: IGRA, for full recommendations on the use of IGRAs.
The IGRA test commonly available in Ontario is the QuantiFERON-TB Gold (QFT) (currently not covered by OHIP) IGRA-QFT testing is available through:
