Q100A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Influenza Vaccine - 60%
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
The Q100A is a Cumulative Preventive Care Management Service Enhancement Code, also known as a Preventive Care Bonus. It is awarded to physicians participating in eligible patient enrollment models who successfully vaccinate 60% of their patient roster against influenza. The bonus amount is $220. This code is submitted with a fee of $0.00 as it serves as a tracking code for the bonus payment.
When to Use
- Use Q100A when your rostered patient population achieves a 60% influenza vaccination rate during the designated flu season reporting period.
- Submit this code once you have confirmed your roster data meets the 60% threshold, as it acts as the trigger for the $220 bonus payment.
Common Pitfalls
- Billing Q100A when your actual rostered vaccination percentage is below 60%, which will result in a rejection or recovery during an audit.
- Submitting a fee other than $0.00 for Q100A, as this is a tracking code and any fee amount will cause a claim rejection.
Billing Tips
- Monitor your preventive care bonus report in the Ministry's portal regularly to track your progress toward the 60% target before submitting the code.
- Ensure your influenza vaccine administration codes (e.g., G538A) are correctly submitted for all patients to ensure they are accurately counted toward your roster's percentage.
Effective: March 1, 2005
AQ. Appendix Q
APPENDIX Q
Other
Other Premiums (including After Hours Procedure Premiums)
Eligible Models: FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO, WHA, CCM and FHG physicians who meet the minimum roster size.
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