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Billing code

Q131A — Mammogram (50 - 74 years)

Mammogram tracking code

Bill Q131A at zero to record a mammogram for an enrolled woman aged 50 to 74, for the mammography preventive care bonus.

Watch for: Expect a zero payment with explanatory code 30; submit it alongside your normal fee-for-service billing.

Code

Q131A

Description

Mammogram (50 - 74 years)

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 that records a mammogram for an enrolled woman aged 50 to 74, for the mammography preventive care bonus.

What it covers

Q131A is the mammography 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.

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 mammography bonus is based on enrolled female patients aged 50 to 74 on March 31 who had a mammogram in the 30 months before March 31 of the fiscal year (OMA Q-codes guide p.16).
• Bonus tiers Q110A to Q114A run from 55% to 75% of that population and are claimed at zero (AQ7–AQ8).
• Appendix Q lists the mammography tiers for RNPGA, BSM, GHC, SJHC, SEAMO, WHA and CCM/FHG physicians who meet the minimum roster (AQ7–AQ8). The April 2026 FHO agreement gives FHO physicians only the influenza and childhood immunization bonuses (Agreement p.65 §8.1).
• Women who have had a mastectomy or are being treated for clinical breast disease are excluded with Q141A (OMA Q-codes guide p.18).

Common rejections

• 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.
• EPA: Q-codes like Q131A are limited to physicians in patient enrolment models; EPA means OHIP doesn't show the physician approved to bill it under the billing number and group used.

Related codes: Q141, Q110, Q114

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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