Billing code
Q015A — Newborn Care Episodic Fee (FHO) (max 8 in first year of life)
Newborn care premium
FHO physicians add Q015A to an A007A well-baby visit for an enrolled baby, up to 8 visits before the first birthday.
Watch for: Bill it only with a valid A007A on the same service date; alone or with another service it is rejected.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $13.99 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- Q015A
- Description
- Newborn Care Episodic Fee (FHO) (max 8 in first year of life)
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
FHO newborn care premium added to an A007 well-baby visit for an enrolled baby, up to 8 visits in the first year of life.
What it covers
Q015A is the newborn care episodic fee for FHO physicians (AQ3). It is a premium paid for each well-baby visit to an enrolled patient in the first year of life (OMA Q-codes guide p.8; Agreement p.73 §11.11). FHN and SEAMO physicians bill Q014A instead (AQ3).
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
- Bill only with a valid A007A on the same service date (OMA Q-codes guide p.8; Agreement p.73 §11.11).
- The service date must be before the patient's first birthday (OMA Q-codes guide p.8).
- Maximum 8 per patient in the first year of life (OMA Q-codes guide p.8; Agreement p.73 §11.11).
- Q015 must accompany each claim for the premium to be paid (Agreement p.73 §11.11).
- For enrolled patients. If the baby's enrolment is processed in the following 12 months, the code is reprocessed automatically when its service date is on or after the signature date on the E/C form (OMA Q-codes guide p.9).
Often billed with
- A007A intermediate assessment or well-baby care, on the same date (A4; OMA Q-codes guide p.8).
- Q200A to enrol the newborn, so the visits count as enrolled-patient visits (OMA Q-codes guide p.9).
Common rejections
- EPA: Q015A is payable only to FHO physicians; EPA means OHIP doesn't show the physician approved to bill it under the billing number and group used.
- AD9: Q015A was billed alone or with a service other than A007A; the OMA guide says this rejects as 'not allowed alone' (OMA Q-codes guide p.8).
- A2A: Q015A was billed with an A007A that has a different service date, or after the first birthday (OMA Q-codes guide p.8–9).
- 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.
- VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated.
Related codes: Q014, A007, Q200
Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), Newborn Care Fees, page AQ3
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