Your Health

How doctors are paid

Most of a doctor’s pay comes from the provincial government. The number of patients and the type of care provided are two major factors that affect a doctor’s earnings.

Fee-for-service payment

Most doctors in Nova Scotia are paid through a fee-for-service model. Doctors bill the government, through Medical Service Insurance (MSI), for each service provided to a patient.

There are thousands of fee codes used to cover the various services provided. All of the fee codes and billing rules are public information and contained in the MSI Physician’s Manual.

The most common fee code a family doctor uses is an office visit. Using this fee code, a family doctor gets paid $30.81 for seeing a patient under 65.

If the service doesn't have a fee code, the government won't pay the doctor for providing it. These are called non-insured services for which the doctor may charge the patient or a third party.

Alternative funding payment

An alternative funding payment model may be used when a doctor is responsible for providing services not covered under the fee-for-service model such as teaching medical students or doing medical research. These services don't have fee codes because fee codes only cover direct patient care.

Alternative funding models may also be used to support the provision of services in rural communities and/or new collaborative models of care.

Most doctors paid through alternative funding plans are specialists working in hospital settings such as Halifax’s Queen Elizabeth II Health Sciences Centre and IWK Health Centre. In some cases, rural doctors are paid under this model.

Each alternative funding agreement is negotiated separately between Doctors Nova Scotia, the Department of Health and Wellness, district health authorities, physicians and, when appropriate, Dalhousie University.


Medical Service Insurance (MSI)
(902) 496-7008