When the WSIB approves additional community treatment after the two standard blocks of the musculoskeletal program of care, the treating professional reports on that supplementary block with this five-page form. It records whether the person completed the block or self-discharged, sessions provided, response to treatment, findings, outcome measures, abilities and restrictions, and changes since the last report.
The registered regulated health professional delivering the program, such as a physiotherapist or chiropractor, completes and signs the whole report.
Download the current version from the source each time; forms change without notice.
Musculoskeletal (MSK) program of care: Supplementary report
Rapport complémentaire dans le cadre du Programme de soins musculo-squelettiques
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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At the end of the supplementary block, within two business days of the last supplementary treatment, submitted online. The WSIB withholds payment for the supplementary block until it receives this report and its billing through TELUS Health, and the report itself is billed under MPOCSBF.
The MSK fee schedule describes the supplementary block as four weeks of treatment, billed as MPOCSSB for a single zone or MPOCMSB for multiple zones. At least three visits are needed for the full block fee; with fewer, the fee is reduced by 50 per cent.
The supplementary report asks whether you are recommending a further supplementary block of treatment. If yes, contact the WSIB and give the treatment frequency, duration and recovery and return-to-work goals; if not, tick that no further treatment is needed. Additional referrals for assessment or intervention go in the same section.