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Billing code

Q012A — After-hours premium

After-hours premium

Add Q012A to eligible visits for enrolled patients seen in scheduled after-hours sessions: weekdays after 5 pm, weekends and statutory holidays.

Watch for: Not for patients seen after 5 pm because the clinic is running late, and Q012A must be on each claim.

Code

Q012A

Description

After-hours premium

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Explanation

Updated October 26, 2026

After-hours premium code added to eligible visits for enrolled patients seen in scheduled evening, weekend or holiday sessions.

What it covers

Q012A is the after-hours premium for FHG, FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO and WHA physicians (AQ2). It has no fee of its own; it tells OHIP to pay a percentage premium on the eligible visit codes on the claim. CCM physicians use Q016A (AQ2).

Appendix Q is information only, not part of the Schedule (AQ1). The rules below come from the 2020 OMA Q-codes guide and, for FHO physicians, the April 2026 FHO agreement (FHO+ terms from April 1, 2026).

Billing rules

• Only for enrolled patients seen in regularly scheduled after-hours sessions, after 5 pm on weekdays or any time on weekends and statutory holidays, never 8 am to 5 pm. Sessions must be open to scheduled and unscheduled patients at times patients are told about (OMA Q-codes guide p.8).
• Not for patients seen after 5 pm because the clinic is running late (OMA Q-codes guide p.8).
• Base codes: A001, A003, A004, A007, A008, A888, E089, K005, K013, K017, K030, K033, K130, K131, K132, Q050; the FHO agreement adds K133 and Q888 (OMA Q-codes guide p.8; Agreement p.68 §8.12; INFOBulletin 260316).
• Q012A must be on each claim (OMA Q-codes guide p.8; Agreement p.68 §8.12).
• Rate: Appendix Q lists 30% (AQ2). For FHO, the April 2026 agreement pays 50% of the full fee during Evening and Weekend Hours and Recognized Holidays (Agreement p.68 §8.12). Check the RA for the rate applied.
• Comprehensive virtual services: 30% of the virtual fee paid (AQ11).
• In an FHO, the group or solo identifier on the claim decides who is paid the premium (Agreement p.58–59 §3.5).

Often billed with

• Base codes such as A007, K005 or K013 (OMA Q-codes guide p.8).
• Q888 for FHO weekend and holiday visits (Agreement p.68 §8.12).

Common rejections

• EPA: Q012A is limited to the listed enrolment models; OHIP doesn't show the physician approved for it under the billing number and group used.
• EH2: The health card version code on the claim doesn't match OHIP's record for the patient; get the current version code and resubmit.
• VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.
• EQE: The physician isn't registered as a member of the group whose number was used on the claim; check the group number.
• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated.

Related codes: Q016, Q017, Q018, Q888, A007, K013

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), After Hours Fees, page AQ2; virtual care premiums, page AQ11

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