OHIP billing code for Q codes

Q codes are OHIP's primary care premium, incentive and roster codes, such as Q012A, Q040A, Q200A and the FHO+ hourly codes.

Code	What it is	Fee
Q012A	After-hours premium	50% premium
Q040A	Diabetes Management Incentive (Annual) Flow Sheet. Min K030 X 3	$65.70
Q200A	Per Patient Rostering	No fee (tracking code)

Q012A: After-hours premium

After-hours premium code added to eligible visits for enrolled patients seen in scheduled evening, weekend or holiday sessions.

Only for enrolled patients seen in regularly scheduled after-hours sessions, after 5 pm on weekdays or any time on weekends and statutory holidays, never 8 am to 5 pm. Sessions must be open to scheduled and unscheduled patients at times patients are told about (OMA Q-codes guide p.8).
Not for patients seen after 5 pm because the clinic is running late (OMA Q-codes guide p.8).
Base codes: A001, A003, A004, A007, A008, A888, E089, K005, K013, K017, K030, K033, K130, K131, K132, Q050; the FHO agreement adds K133 and Q888 (OMA Q-codes guide p.8; Agreement p.68 §8.12; INFOBulletin 260316).
Q012A must be on each claim (OMA Q-codes guide p.8; Agreement p.68 §8.12).
Rate: Appendix Q lists 30% (AQ2). For FHO, the April 2026 agreement pays 50% of the full fee during Evening and Weekend Hours and Recognized Holidays (Agreement p.68 §8.12). Check the RA for the rate applied.

EPA: Q012A is limited to the listed enrolment models; OHIP doesn't show the physician approved for it under the billing number and group used.
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.
VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.
EQE: The physician isn't registered as a member of the group whose number was used on the claim; check the group number.
VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated.

Annual diabetes management incentive for the family physician most responsible for a diabetic patient, after at least three K030 visits.

Maximum one per patient per 12-month period (A53).
Payable only if the physician billed at least three K030 for the same patient in the same 12-month period (A53).
A flow sheet or other record of all required CDA elements must be in the patient's permanent record, or it isn't payable (A53).
Submit only once the required elements are complete for the previous 12 months (A53).
Can be submitted alone or with other fee codes (OMA Q-codes guide p.12).

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.

No-fee rostering code that tells OHIP a patient has enrolled with the physician. The service date is the date on the signed enrolment form.

Submit Q200A when a patient enrols with the physician (OMA Q-codes guide p.9).
The service date must be the date on the Patient Enrolment and Consent to Release Personal Health Information (E/C) form (OMA Q-codes guide p.10).
Since February 1, 2013, the E/C form is kept in the office for your records, not sent to the Ministry (OMA Q-codes guide p.10).
Bill it at zero (AQ3; OMA Q-codes guide p.9).
Long-term care patients are rostered with Q202A instead, in FHN and FHO (OMA Q-codes guide p.10).

EP1: OHIP didn't accept the enrolment transaction; in APEX's claims data the usual cause is a Q200A sent under the solo billing number (group 0000) instead of the enrolment group's number.
VJ7: The service date must be the E/C form date, so a Q200A sent more than three months after the form was signed is stale-dated.
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.
EQF: The physician is linked to the group on the claim, but the membership wasn't active on the E/C form date.
EQD: The group number on the claim wasn't active with the Ministry on the service date.

Q codes are OHIP's primary care premium, incentive and roster codes, such as Q012A, Q040A, Q200A and the FHO+ hourly codes.

Updated October 26, 2026.