Changes in BMD testing in Ontario – An Update
April 24, 2026
Contributors: Dr. Adrian Lau, Dr. Heather McDonald-Blumer, Dr. Laëtitia Michou, Dr. Claudia Gagnon, Dr. Zahra Bardai , Dr. Vithika Sivabalasundaram, Sarah Rydahl, Dr. Shirine Usmani,
As of April 1, 2026, the ability to obtain a Bone Mineral Density (BMD) test in the province of Ontario has significantly changed. The new OHIP criteria for bone density assessment partially meets Osteoporosis Canada 2023 Guideline recommendations for follow up. However, the current OHIP criteria do not allow for specific circumstances where bone experts recognize that testing done between 1 and 3 years will support better decision-making and potentially better care for individuals with osteoporosis.
A summary of the changes introduced by the Ontario Health Insurance Plan (OHIP) Schedule of Benefits is outlined in a previous Rapid Response statement: Changes in BMD Testing in Ontario.
Implications thus far:
- Some clinics and hospitals have continued to perform all BMD tests for their patients even though this service may not be funded under the new regulations. Other locations that have routinely done BMD assessments may have cancelled all tests that no longer meet OHIP criteria.
- Many Ontarians have had their BMD tests cancelled since April 1, 2026.
- Unless an individual has hypercortisolism/Cushing’s syndrome or is receiving high-dose glucocorticoid therapy such as Prednisone 20 mg per day or greater, they may not have another BMD until 3 years after their previous test.
- Some Ontarians have had scheduled appointments with their healthcare professionals to discuss their bone health, but without new BMD results.
- A repeat BMD may have been ordered several years ago, to be done in April 2026, to reassess bone density status. That test may not be currently available through OHIP, given the new criteria for bone density follow up.
- Self funding of medically necessary bone density testing is not allowed under OHIP rules.
- It is recognised that new BMD results could inform a patient’s course of treatment: a stable BMD may have resulted in a cessation of pharmacotherapy for some, whereas a declining BMD may have resulted in initiation or change of medications for others.
- Some Ontarians may have deferred or cancelled their appointments to discuss their bone health with their healthcare professionals, knowing that they did not have a new bone density test to discuss.
- Patients may not have seen the value of seeing their medical team to review their bone health.
- These cancelled appointments could result in unaddressed factors and unoptimized lifestyle factors for bone health, potentially leading to further ongoing undetected bone loss and fragility fractures.
Progress thus far:
Given the concern that new OHIP funding criteria does not fully align with the recommendations in the Osteoporosis Canada 2023 Clinical Practice Guideline for bone density testing intervals and does not allow for expert clinical judgement, a negotiating team is working to find a solution.
- Physician representatives from Diagnostic Imaging, Nuclear Medicine, Rheumatology and Endocrinology have met with officials from the Ministry of Health and Ontario Medical Association to discuss their concerns.
- Negotiations are in progress, with positive steps being discussed although a clear resolution is yet to be determined.
Consequences:
- A resolution to this issue needs to be well thought out and may take time.
- Until a solution is agreed upon – interim or long-term, many BMD tests will continue to be cancelled.
- This has a potentially negative impact on patient care.
- An estimated 500,000 BMD tests were performed in Ontario in 2005 (1), or an average of about 10000 tests per week.
- This number is surely much higher in 2026.
- As more BMD tests are cancelled, there is risk of more physician visits being deferred, which may compromise patient care.
Call to Action:
- The Ministry of Health has heard from experts in the field.
- Patient voices are needed.
- Osteoporosis Canada urges everyone to have your voices heard.
- Share this campaign with friends, family and healthcare providers
- Copy and paste this link: https://actnow.osteoporosis.ca/page/190660/action/1 and post on your social platforms and send via email so that others can also send their messages of support
- Share your personal story with Ontario’s Ministry of Health leaders and elected provincial politicians
- Follow and interact with Osteoporosis Canada on Facebook, Instagram and LinkedIn
References: