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Q023A
Q023A – Unattached Patient Fee
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
The Unattached Patient Fee (Q023A) is a payment of $150.00 for services rendered to an unattached patient. This fee is available to physicians participating in specific primary care models. For complete billing requirements, refer to the Primary Health Care Fact Sheets.
When to Use
- Use Q023A when providing a comprehensive assessment to a patient who is not enrolled in your primary care practice or any other FHO/FHN/FGP group.
- Apply this code when you accept a patient into your practice who was previously unattached, provided the service meets the specific criteria for a new patient intake assessment.
Common Pitfalls
- Billing Q023A for a patient who is already rostered to another physician in a primary care model will result in a rejection.
- Attempting to bill Q023A in conjunction with Q043A for the same patient encounter is a common error that leads to payment recovery during audits.
Billing Tips
- Ensure the patient's status as 'unattached' is verified through the Ministry's patient enrollment database to prevent retroactive clawbacks.
- Always link the Q023A code to the specific assessment visit code (such as A007A) to establish the clinical context of the intake.
Provider Fee$150.00
Effective: April 1, 2025
Category
AQ. Appendix Q
Subcategory
APPENDIX Q
Service Type
Other
Code Classes
Other Premiums (including After Hours Procedure Premiums)
Please Refer to the Primary Health Care Fact Sheets for complete billing information.
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