An older couple at home in their kitchen, talking over a tablet.

For registered vendors and clinic administrators

ODSP and Ontario Works on a funded invoice.

Q: Our client is on ODSP. Who pays the 25% on a funded CPAP?

Nobody pays you a 25% share on that invoice. For respiratory equipment, where the client receives Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities as of the date the prescriber reviewed and approved the application, the Assistive Devices Program pays 100% of the approved price, or the approved monthly rental charge on a rented device. The invoice carries the benefit code for that programme, and the client's usual 25% is simply not part of the sale.

Q: And for a device that is not respiratory equipment?

There the social assistance programme covers the recipient's consumer contribution, up to the amount the Assistive Devices Program approved. In practice the programme pays that contribution on the social ministry's behalf and bills it back to the ministry by journal entry, so the vendor does not collect it and does not invoice the ministry for it. Where the device costs more than the programme's maximum, the recipient is responsible for the difference.

Q: Do we invoice ODSP or Ontario Works directly?

No. The vendor invoices the Assistive Devices Program, and the benefit code on that invoice says which social assistance programme applies. The share the client would otherwise have paid is settled between the ministries rather than at your counter.

Q: How is the client's status confirmed?

The ministry checks the Registered Persons Data Base for the month the assessment was done. Where it cannot confirm that the person receives income support, the vendor is required to ask the recipient for verification, and a cheque stub or a direct bank deposit stub is accepted. Getting that into the file at the point of sale is the vendor's job, not the ministry's.

Q: The client bought the device before approval came through. Can social assistance cover it?

No. Both directives say a device purchased before it is authorized for Assistive Devices Program funding receives no funding assistance, and the applicant or recipient is responsible for the cost. The order of events decides who pays, so the authorization belongs before the sale, not after it.

Q: Do these two programmes come set up as payers?

Both are in the payer directory. The Assistive Devices Program is the one payer whose coverage rule ships set up, as a percentage of a named approved price; every other rule your clinic enters once, and it applies from then on.

The Ontario Disability Support Program (ODSP) and Ontario Works are Ontario's two social assistance programmes. This page is about where a recipient's share lands on a vendor's invoice, and the one rule that works differently for respiratory equipment.

Book a demo See the two rules

Respiratory: 100% of the approved price Other categories: the client contribution Settled between ministries

Two rules, kept apart

Who carries the client's share.

Respiratory equipment follows one published rule, and the other device categories follow another. Both are sourced and dated at the foot of this page.

Respiratory equipment: 100%

Where the client receives Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities as of the date the prescriber reviewed and approved the application, the Assistive Devices Program pays 100% of its approved price, or 100% of the approved monthly rental charge on a rented device.

The programme itself pays the whole approved price. The social assistance programme does not pay you a 25% share.
The invoice carries the benefit code saying which social assistance programme applies.
Items outside the funded system are still billable to the client in full.

Other device categories: the contribution

For a device in another Assistive Devices Program category, the social assistance programme covers the recipient's consumer contribution, up to the amount the programme approved.

The programme pays that contribution on the social ministry's behalf and bills it back to the ministry by journal entry, so nothing is collected at your counter.
Where the device costs more than the programme's maximum, the recipient is responsible for the difference.
Hearing aids and personal FM systems are the published exception: the ministry does not cover the 25% contribution there.

Sample

A positive airway pressure system for a recipient

A positive airway pressure system for a recipient
Item	Amount
Positive airway pressure system, approved price	$554.00
Invoice total	$554.00
Assistive Devices Program (ADP) 100% of the approved price, benefit code on the claim	-$554.00
Patient owed	$0.00

Sample figures, not a real patient. Nothing is left for the client on the funded device, and the benefit code on the invoice says which social assistance programme applies.

Sample figures, not a real patient. Invoice lines carry no tax unless the catalogue item is taxable, and respiratory supplies are set up zero rated.

What the clinic records

The parts a vendor is responsible for.

Four published rules that decide whether a funded invoice is payable, and one link for the programme behind them.

Proof that the client is a recipient

The ministry verifies the client's status through the Registered Persons Data Base for the month the assessment was done. Where it cannot confirm that the person receives income support, the vendor is required to seek verification from the recipient, and a cheque stub or a direct bank deposit stub is enough.

The benefit code on the invoice

The invoice to the programme carries a code saying whether the client is on the Ontario Disability Support Program, Ontario Works, Assistance for Children with Severe Disabilities, or none of them. It is the code that turns the usual case into the 100% case.

Assistive Devices Program (ADP) billing for CPAP clinics

Authorization comes before the sale

A device purchased before it is authorized for programme funding gets no funding, and both social assistance directives say the applicant or recipient carries that cost. There is no later benefit code that rescues an invoice raised too early.

Repairs, maintenance and assessments

The programme does not cover maintenance or repairs, and the social assistance programmes cover batteries and repairs for mobility devices where nothing else does. Respiratory equipment, oxygen and ventilators are named among the categories with no assessment fee; where a fee does exist and no other source funds it, the social assistance programme covers it.

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Invoices / INV-10844

Payer allocations

Add payer

On this invoice

Payer	Rule	Status
Assistive Devices Program (ADP)	100% of approved price	Approved
Patient portion	Remainder	Nil

Programme share

Approved price: $554.00
Programme share: $554.00
Benefit code: Recorded
Patient portion: $0.00

In norvelle

Where the balance lands on the invoice.

One invoice at your price, with the programme share on it. A benefit code does not create a second payer: it changes the size of the one you already have.

Set the programme's share for that invoice, and the patient's remainder is worked out from what is left.
Where a benefit code applies to a funded respiratory device, nothing is left for the patient on that line.
Lines the programme does not fund stay where they belong, with a private plan or the patient, and collections chases the patient's portion only.
The approval reference is captured on the programme's share, and the payer can be set to require one.
The printed invoice can carry a funding-audit signature declaration naming the parties, set per brand and per location.

How one invoice carries more than one payer at all: funding programmes and payer billing.

Questions vendors ask.

Our client is on ODSP. Who pays the 25% on a funded CPAP?

And for a device that is not respiratory equipment?

Do we invoice ODSP or Ontario Works directly?

How is the client's status confirmed?

The client bought the device before approval came through. Can social assistance cover it?

Do these two programmes come set up as payers?

Sources

Captured 2026-10-18. Every programme fact on this page was read from the Ontario government's own published directives and manuals on that date. Programme rules change: check the source before you rely on it.

100% of the approved price, or the approved monthly rental charge, for clients receiving Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities as of the date reviewed and approved by the prescriber: Respiratory Equipment Policy and Administration Manual, policy 605, with the fixed price model at policy 600, ontario.ca/files/2024-11/moh-adp-policy-and-administration-manual-respiratory-equipment-2024-11-08.pdf (July 2024).
The ministry paying a recipient's consumer contribution for a device funded by the Assistive Devices Program up to the amount that programme approved, the programme paying the contribution on the ministry's behalf and billing it back by journal entry, verification through the Registered Persons Data Base for the month of the assessment, the vendor being required to seek verification from the recipient where the programme cannot confirm it, assessment fees where no other source funds them, no funding for a device bought before authorization, and the categories with no assessment fee including oxygen, ventilators and respiratory equipment: Ontario Disability Support Program directive 9.6, ontario.ca/document/ontario-disability-support-program-policy-directives-income-support/96-assistive-devices (updated 2026-03-10).
The remaining 25% paid directly by the ministry with the programme billing the ministry for it, the recipient paying the difference where the device costs more than the programme maximum, hearing aids and personal FM systems as the exception where the ministry does not cover the contribution, batteries and repairs for mobility devices as a mandatory benefit, and no funding for a device bought before authorization: Ontario Works directive 7.8, ontario.ca/document/ontario-works-policy-directives/78-assistive-devices (updated 2026-04-14).
The benefit code on the vendor invoice saying which social assistance programme applies, and the other essential invoice data items: Policies and Procedures Manual for the Assistive Devices Program, policies 915.01 to 915.04, files.ontario.ca/moh-adp-policies-and-procedures-manual-assistive-devices-program-2023-07-01.pdf (July 2023).

See a funded invoice with a benefit code.

Watch the programme share, the reference and the patient remainder land on one invoice.

Book a demo See Assistive Devices Program billing