Q104A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Influenza Vaccine - 80%
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
This is a Cumulative Preventive Care Management Service Enhancement Code for the Influenza Vaccine bonus. It is used for tracking purposes when a physician in an eligible patient enrolment model achieves an 80% influenza vaccination rate for their designated patient population. The associated bonus payment is $2200. The code itself should be billed with a fee of $0.00. Eligible models include FHN, FHO, RNPGA, BSM, GHC, SJHC, SEAMO, WHA, CCM and FHG. The physician must also meet the minimum roster size to be eligible.
When to Use
- Use Q104A when your rostered patient population in an eligible model reaches the 80% influenza vaccination threshold for the designated fiscal year.
- Submit this code only after confirming your roster meets the minimum size requirements for the specific enrollment model (e.g., FHO or FHG) to qualify for the $2200 bonus.
Common Pitfalls
- Billing Q104A without verifying the specific roster count, as failing to meet the minimum threshold will result in an automatic rejection of the bonus payment.
- Confusing Q104A with Q100A-Q103A, which represent different tiers of vaccination coverage; ensure your calculated percentage strictly meets the 80% requirement.
Billing Tips
- Submit the code with a fee of $0.00, as the payment is triggered by the Ministry's automated reconciliation process once the threshold criteria are met.
Effective: March 1, 2005
AQ. Appendix Q
APPENDIX Q
Other
Other Premiums (including After Hours Procedure Premiums)
The bonus payment associated with achieving this 80% vaccination target is $2200.
This fee code is submitted with a fee of $0.00 for tracking purposes.
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