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Billing code

Q313A — FHO+ hourly clinical administration

FHO+ hourly clinical administration

FHO physicians bill Q313A for roster-wide work needing a physician, such as screening outreach, EMR work and quality improvement, in 15-minute units.

Watch for: Capped at 5% of the month's direct and indirect hourly payments, and never for clinic operations like staff or finance.

Code

Q313A

Description

FHO+ hourly clinical administration

FHO+ basket

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

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

FHO+ hourly code for clinical administration for the roster: screening outreach, EMR work and quality improvement needing a physician.

What it covers

Q313A pays FHO physicians by the hour for work that needs a physician's expertise to manage their roster or all enrolled patients of the FHO (Agreement p.62 §6.1(iv)).

It covers proactive roster review for screening and disease management (for example mammograms, colon cancer screening, immunizations, diabetes); EMR work needing physician expertise; and quality improvement, access and equity, and digital health change work (Agreement p.62–63 §6.1(iv)).

It is one of the four FHO+ hourly codes (Q310A–Q313A) in the April 2026 FHO agreement, not the Schedule or Appendix Q, payable to FHO and FHO contracted physicians (Agreement p.61 §6.1).

Billing rules

• Not for clinic operations such as staff, finance, supplies, leases or insurance, nor for patient-specific work (Q312A) or direct care (Agreement p.63 §6.2).
• Billed in 15-minute units per day, totalled across enrolled patients; 8 minutes or more left over counts as a unit (Agreement p.63 §6.3–6.4).
• Only in the usual family practice setting, including LTC homes and home visits, for enrolled patients (Agreement p.61 §6.1).
• Not for ED, in-hospital work (including labour and delivery), anaesthesia, surgical assist, Independent Health Facilities, non-enrolled patients, uninsured services or travel time (Agreement p.63 §6.5).
• All hourly codes together: at most 14.0 hours a day and 240.0, 248.6, 257.1 or 265.7 hours in a 28-, 29-, 30- or 31-day month (Agreement p.63–64 §6.6).
• Q313A can't exceed 5% of the month's hourly payments for direct and indirect care, and Q312A plus Q313A can't exceed 25% of the month's total (Agreement p.64 §6.7).
• Keep a daily time record with a summary of the activities, for Ministry review (Agreement p.64 §6.8).

Often billed with

• Q310A and Q312A, since the clinical administration limit is a share of the month's direct and indirect care hours (Agreement p.64 §6.7(b)).

Common rejections

• V42: The number of services was missing or invalid; it must be two digits from 01 to 99, and for Q313A it is the number of 15-minute units (Agreement p.63 §6.4).
• V41: Since May 1, 2026, hourly codes billed at $0.00 reject V41 for service dates from April 1, 2026; bill the value of the units claimed (INFOBulletin 260501).
• VH1: The health number on the claim was blank or invalid; check how your billing software fills the patient fields on hourly claims.
• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated.

Related codes: Q310, Q311, Q312

Source: Not in the Schedule of Benefits; FHO Physician Payment Agreement (April 2026), Appendix I §6 Hourly Payments, pages 61–64

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