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Billing code

Q050A — Heart Failure Management Incentive (Annual)

Heart failure management incentive

Bill Q050A once a year for an enrolled heart failure patient when all required care elements are documented on a flow sheet.

Watch for: Claim only once the flow sheet is complete: physical exam, lab monitoring, patient education and medication management.

Code

Q050A

Description

Heart Failure Management Incentive (Annual)

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

Annual incentive for coordinating and documenting all required heart failure care elements on a flow sheet for an enrolled patient.

What it covers

Q050A is the heart failure management incentive: an annual payment for coordinating and documenting all required elements of care for enrolled patients with heart failure (AQ2; OMA Q-codes guide p.13; Agreement p.72 §11.4).

It needs a flow sheet kept in the patient's record, consistent with the Canadian Cardiovascular Society heart failure recommendations of 2006 and 2007. The Heart Failure Patient Care Flow Sheet or a similar one may be used, and it is meant to be completed over the year (OMA Q-codes guide p.13). Appendix Q is information only, not part of the Schedule (AQ1).

Billing rules

• Claim once a year for an enrolled heart failure patient, once all required elements of the patient's care are documented and complete (OMA Q-codes guide p.13).
• The flow sheet must track: comprehensive physical exam; lab monitoring of Na+, K+, serum creatinine and eGFR; patient education on modifiable risk factor reduction and self-management; and pharmacologic management with first-line, symptom-relief and preventive medications (OMA Q-codes guide p.13).
• Eligible models: CCM, FHG, FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO and WHA (AQ2).
• Q050A is one of the codes the after-hours premium is paid on, with Q012A on the claim, for enrolled patients seen in eligible after-hours sessions (OMA Q-codes guide p.8; Agreement p.68 §8.12).

Often billed with

• Q012A after-hours premium when the service is in a scheduled evening, weekend or holiday session; Q050A is a listed base code (OMA Q-codes guide p.8; Agreement p.68 §8.12).

Related codes: Q040, Q042, Q012, Q200

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), Chronic Disease Management, page AQ2; OMA Q-codes guide p.13; FHO agreement p.72 §11.4

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