< Billing codes

Billing code

Q042A — Smoking Cessation Counselling Fee (2/yr)

Smoking cessation follow-up

Bill Q042A for a dedicated follow-up counselling session with an enrolled patient who committed to quit smoking, up to two a year.

Watch for: Payable only after a paid E079 initial smoking cessation discussion in the previous 12 months.

Code

Q042A

Description

Smoking Cessation Counselling Fee (2/yr)

FHO+ basket

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

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Fee for a dedicated smoking cessation follow-up session with an enrolled patient who committed to quit. Max 2 a year, after E079.

What it covers

Q042A is an extra fee for a dedicated follow-up counselling session with an enrolled patient who has committed to quit smoking (OMA Q-codes guide p.12; Agreement p.73 §11.9). Eligible models: CCM, FHG, FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO and WHA (AQ2); the virtual care table also lists GP Focused HIV (AQ11).

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

• Maximum two per patient per year (AQ2; OMA Q-codes guide p.13; Agreement p.73 §11.9).
• OMA guide: payable only if the physician previously billed a valid E079A, and K039 is billed in the 12 months after the E079 service date (OMA Q-codes guide p.13).
• FHO agreement: payable for enrolled patients who committed to quit within 12 months of the E079A (Agreement p.73 §11.9).
• In group-enrolment models, payable for patients affiliated to the physician on the E/C form (OMA Q-codes guide p.13).
• E079 is the initial smoking cessation discussion, an add-on to listed visits, once per patient per 12 months. K039 is the follow-up visit, payable only when E079 was payable to the same physician in the previous 12 months, maximum two (A56).
• Payable with eligible comprehensive virtual care services (AQ11).

Often billed with

• K039 smoking cessation follow-up visit, in the 12 months after E079 (A56; OMA Q-codes guide p.13).

Common rejections

• PAA: OHIP found no paid E079 initial smoking cessation fee for the patient in the prior 365 days, which Q042A depends on (OMA Q-codes guide p.13).
• EPA: Q042A 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.
• 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.

Related codes: E079, K039

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), Chronic Disease Management, page AQ2

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing