All codes
Q018A
Q018A – GP focus – COE1 after-hours fee
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
The Q018A is a premium payable to physicians providing eligible comprehensive virtual care services. It increases the fee of the associated virtual service by 30%. This premium is specifically for physicians participating in a GP Focused Care of the Elderly (COE) model.
When to Use
- Use Q018A when billing a virtual assessment code (e.g., K080A or K081A) for an enrolled patient within a GP Focused Care of the Elderly (COE) practice model.
- Apply this premium when providing eligible virtual care services during designated after-hours periods as defined by the Schedule of Benefits for your specific practice designation.
Common Pitfalls
- Billing Q018A without an eligible base virtual care code will result in an automatic rejection as it is a percentage-based premium, not a standalone service.
- Attempting to claim Q018A for in-person visits or non-virtual services is a common audit trigger, as this premium is strictly restricted to virtual care delivery.
Billing Tips
- Ensure your billing software is configured to automatically link Q018A to the base virtual fee to avoid missing the 30% uplift on eligible claims.
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), Virtual Care Services
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