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Billing code

Q100A — Preventive care bonus, influenza 60%

Flu vaccine bonus, 60% tier

Bill Q100A at zero when 60% of your enrolled patients aged 65 or older got this season's flu vaccine by January 31.

Watch for: One influenza bonus claim a year: bill only the tier code for the coverage you actually reached.

Code

Q100A

Description

Preventive care bonus, influenza 60%

FHO+ basket

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

Effective date

Mar 1, 2005

Termination date

No end date

Explanation

Updated October 26, 2026

Zero-fee claim for the influenza preventive care bonus when 60% of enrolled patients aged 65+ got the season's flu vaccine by January 31.

What it covers

Q100A is the first tier of the influenza cumulative preventive care bonus: the service enhancement code claimed when 60% of the target population received the influenza vaccine (AQ5). The other tiers are Q101A (65%), Q102A (70%), Q103A (75%), Q104A (80%) (AQ5; Agreement p.65 §8.1).

The target population is enrolled patients aged 65 or older on December 31 of the fiscal year, and the vaccine must be the one for that influenza season, given by January 31 (OMA Q-codes guide p.15; Agreement p.65 §8.1). Appendix Q is information only, not part of the Schedule (AQ1).

Billing rules

• Bill at zero; the Ministry pays the bonus on the valid claim (AQ5; Agreement p.66 §8.2).
• One bonus a year per preventive care category (OMA Q-codes guide p.15); the FHO agreement allows one claim per year under the influenza heading, so claim only the tier code for the coverage reached (Agreement p.65 §8.1).
• FHO: calculated annually for each FHO physician individually (Agreement p.65 §8.1).
• Eligible: FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO and WHA physicians, and CCM and FHG physicians who meet the minimum roster size (AQ5). That minimum is 650 enrolled patients on March 31 of the bonus year, or 450 for new graduates in their first year in an FHG or CCM; FHO and FHN have no minimum (OMA Q-codes guide p.15).
• FHO: prorated for practices with fewer than 1,000 enrolled patients (Agreement p.66 §8.2).
• The Q130A tracking code identifies a patient as having received the flu vaccine, which helps determine the coverage level reached (OMA Q-codes guide p.17–18).

Common rejections

• V98: OHIP's description is 'wrong preventive care service date'. Appendix Q and the OMA guide don't say which service date a bonus claim needs; Appendix Q refers to the Ministry's Primary Health Care fact sheets for complete billing information (AQ1). Check the date there, correct it and resubmit.

Related codes: Q101, Q102, Q103, Q104, Q130, G590

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), Preventive Care Fees and Bonuses, page AQ5; OMA Q-codes guide p.15–18; FHO agreement p.65–66 §8.1–8.2

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