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Billing code

Q115A — Preventive care bonus, childhood immunizations 85%

Childhood immunization bonus, 85%

Bill Q115A at zero when 85% of your enrolled children aged 30 to 42 months are fully immunized.

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

Code

Q115A

Description

Preventive care bonus, childhood immunizations 85%

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

Childhood immunization preventive care bonus, first tier: billed at zero once 85% of enrolled children aged 30 to 42 months are fully immunized.

What it covers

Q115A is the 85% tier of the childhood immunization category of the cumulative preventive care bonus (Q115A 85%, Q116A 90%, Q117A 95%) (AQ8-AQ9). Unlike the Pap, mammography and colorectal tiers, it is open to FHO and FHN physicians (AQ6-AQ10; Agreement p.65 §8.1).

The target population is enrolled patients aged 30 to 42 months inclusive on March 31 of the fiscal year being claimed. A child counts when they received all the Ministry-supplied immunizations recommended by the National Advisory Committee on Immunization by 30 months of age (Agreement p.65 §8.1; OMA Q-codes guide p.17).

Appendix Q is information only and not part of the Schedule (AQ1).

Billing rules

• Bill at zero (AQ8).
• Eligible: FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO, WHA, and CCM and FHG physicians who meet the minimum roster size (AQ8).
• FHO: one claim per year under the childhood immunization heading (Agreement p.65 §8.1).
• FHO practices with fewer than 1,000 enrolled patients receive the bonus on a prorated basis (Agreement p.66 §8.2).
• FHG and CCM physicians need at least 650 enrolled patients on March 31 of the bonus year (450 for new graduates in their first year); FHO and FHN physicians have no minimum (OMA Q-codes guide p.15).
• Children whose immunizations are complete are recorded with the zero-fee tracking code Q132A (OMA Q-codes guide p.7, p.18).

Common rejections

• V98: OHIP's description is 'wrong preventive care service date'. Appendix Q doesn't state the service date rule for the bonus claims; it refers to the Ministry's Primary Health Care fact sheets for complete billing information (AQ1). Correct the service date per the fact sheet and resubmit.

Related codes: Q116, Q117, Q132, Q100, Q104, G841, G845

Source: Schedule of Benefits (July 1, 2026), Appendix Q (information only), Preventive Care Fees and Bonuses, pages AQ8-AQ9 and AQ1; FHO Agreement 2026-04 pp.65-66 §8.1-8.2; OMA Primary Care Q-Codes Quick Reference Guide (November 2020), pages 6-7, 15 and 17-18

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