All codes
Q017A
Q017A – HIV after-hours fee
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
This is a premium that provides a 30% increase on eligible services rendered during after-hours periods by physicians in the GP Focused HIV model. It is also payable for eligible comprehensive virtual care services, calculated as 30% of the virtual fee paid.
When to Use
- Use Q017A when providing eligible HIV-related clinical services during designated after-hours periods as defined in the GP Focused HIV model schedule.
- Apply this code to eligible comprehensive virtual care services provided to patients enrolled in the HIV model to receive the 30% premium on the virtual fee.
Common Pitfalls
- Billing Q017A for services rendered during standard office hours, which will result in an automatic rejection as the premium is strictly for after-hours or specific virtual care eligibility.
- Attempting to claim Q017A in conjunction with other non-eligible premiums or outside of the GP Focused HIV model, which triggers audit flags for inappropriate premium stacking.
Billing Tips
- Ensure the primary service code is eligible under the GP Focused HIV model before appending Q017A, as the 30% calculation is dependent on the base fee paid for the core service.
Percentage Premium: 0.3%
This code applies a percentage increase to the base procedure fee
Provider Fee$0.01
Effective: April 3, 2020
Category
AQ. Appendix Q
Subcategory
APPENDIX Q
Service Type
PercentageIncrease
Code Classes
Other Premiums (including After Hours Procedure Premiums)
Eligible Models: HIV ().
Eligible Models: GP Focused HIV ().
For virtual care, the fee is 30% of the virtual fee paid ().
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