Q103A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Influenza Vaccine - 75%
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
This is a Cumulative Preventive Care Management Service Enhancement Code, also known as a Preventive Care Bonus. It is applicable when a physician achieves an influenza vaccination rate of 75% for their eligible rostered patients. The code itself is submitted with a fee of $0.00, and successful submission based on Ministry data results in a bonus payment of $1100. Eligibility is restricted to physicians in specific models who meet the minimum roster size.
When to Use
- Use Q103A when your Ministry-calculated influenza vaccination rate for your rostered patients reaches exactly 75% to 79.9%.
- Submit this code once per fiscal year as the primary indicator that you have met the 75% threshold for the Preventive Care Bonus.
Common Pitfalls
- Failing to ensure that all influenza vaccines administered are billed with the correct diagnostic code, as unbilled vaccines will not count toward your 75% target.
- Attempting to bill Q103A in addition to Q100A, Q101A, Q102A, or Q104A, which will result in a rejection as only one tier of the preventive care bonus is payable per period.
Billing Tips
- Monitor your Ministry-provided Preventive Care Bonus reports regularly to track your current vaccination percentage and ensure your rostered patient list is accurate before the fiscal year-end.
Effective: March 1, 2005
AQ. Appendix Q
APPENDIX Q
ManagementFee
Other Premiums (including After Hours Procedure Premiums)
While no specific documentation is required for this bonus code itself, the underlying influenza vaccination services for rostered patients must be accurately documented and billed to be counted towards the target percentage. General medical record requirements as per must be met for all patient encounters.
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