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Billing code

Q130A — Influenza Vaccine (65 & over)

Flu vaccine tracking code

Bill Q130A at zero to record that an enrolled patient aged 65 or older got this season's flu vaccine, for the influenza bonus.

Watch for: Expect a zero payment with explanatory code 30, and bill it with the A suffix and your normal billing.

Code

Q130A

Description

Influenza Vaccine (65 & over)

FHO+ basket

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

Effective date

Mar 31, 2004

Termination date

No end date

Explanation

Updated October 26, 2026

Zero-fee tracking code showing an enrolled patient aged 65+ got this season's flu vaccine, for the influenza preventive care bonus.

What it covers

Q130A is the influenza vaccine tracking code (OMA Q-codes guide p.7, p.18). Tracking codes mark a patient as having received a preventive service, which counts toward the physician's preventive care bonus percentage for that category (OMA Q-codes guide p.17).

It is not in the Schedule or Appendix Q. The source is the 2020 OMA Q-codes guide; the influenza bonus itself is in Appendix Q and the April 2026 FHO agreement.

Billing rules

• Bill at zero. The remittance advice pays zero with explanatory code 30, 'this service is not a benefit of OHIP' (OMA Q-codes guide p.17).
• Submit it with your normal fee-for-service and premium billing (OMA Q-codes guide p.17).
• The influenza bonus target population is enrolled patients aged 65 or older on December 31 of the fiscal year, vaccinated for that season by January 31 (OMA Q-codes guide p.15; Agreement p.65 §8.1).
• Bonus tiers Q100A to Q104A run from 60% to 80% of the target population and are claimed at zero, once per fiscal year (AQ5; Agreement p.65 §8.1).
• Eligible: FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO, WHA, and CCM/FHG physicians who meet the minimum roster of 650 enrolled patients on March 31, or 450 for new graduates in their first year (AQ5; OMA Q-codes guide p.15).
• For FHO practices under 1,000 enrolled patients the bonus is prorated (Agreement p.66 §8.2).

Common rejections

• V23: OHIP flagged the number of services; this usually means a B- or C-suffix code was billed with one service, while Q130 is billed with the A suffix (OMA Q-codes guide p.18).
• 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.
• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated.

Related codes: Q100, Q104, G590, Q590

Source: Not in the Schedule of Benefits; OMA Primary Care Q-Codes Quick Reference Guide (November 2020), Tracking and Exclusion Codes, pages 7 and 17–18

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