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Billing code

Q023A — Unattached Patient Fee

Unattached patient after hospital stay

Bill Q023A once when you enrol a patient with no family physician who had an acute-care hospital stay in the previous three months.

Watch for: Use the date on the signed enrolment and Unattached Patient Declaration forms as the service date; only one such fee per patient.

Code

Q023A

Description

Unattached Patient Fee

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

One-time fee for enrolling a new patient with no family physician who had an acute-care hospital stay in the previous three months.

What it covers

Q023A is a new patient fee for enrolling a patient who had no family physician at the time of enrolment and had an acute-care hospital in-patient stay within the previous three months (OMA Q-codes guide p.10; Agreement p.70 §10.1). Eligible models: CCM, FHG, FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO and WHA (AQ1).

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

• The service date must be the date on the E/C (enrolment and consent) form and the Unattached Patient Declaration form (OMA Q-codes guide p.10).
• The patient (or guardian) and the physician complete both forms (OMA Q-codes guide p.10); FHOs keep Form B.2 on file (Agreement p.70 §10.1).
• No limit on the number of Q023A claims a physician can make (OMA Q-codes guide p.10).
• Only one unattached patient fee may be claimed for any individual patient (OMA Q-codes guide p.10).
• Newborns qualify when the mother has no family physician and the baby was admitted to a Level II or higher NICU in the last three months (OMA Q-codes guide p.10); the FHO agreement says any NICU admission (Agreement p.70 §10.1).
• In an FHO, the group or solo identifier on the claim decides whether the fee is paid to the group or the physician (Agreement p.58–59 §3.5).

Often billed with

• Q200A rostering code for the same patient (OMA Q-codes guide p.10).

Common rejections

• EPA: Q023A is limited to physicians in the listed enrolment models; EPA means OHIP doesn't show the physician approved to bill it under the billing number and group used on the service date.
• 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.
• V70: The Ministry's description for V70 is a service date later than the claim file or batch creation date; the Q023A service date should be the date on the signed forms.
• R04: The Ministry's description for R04 is a service excluded from reciprocal medical billing (RMBS), the route for out-of-province patients.

Related codes: Q200, Q043, Q053

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), New Patient Fees, page AQ1

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