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Q111A
Q111A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Mammography - 60%
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
The Q111A is the Cumulative Preventive Care Management Service Enhancement Code, also known as the Preventive Care Bonus for Mammography. This bonus is for achieving a 60% screening target and corresponds to a payment of $440. The service must be billed at $0.00. It is only eligible for physicians in the following models who meet the minimum roster size: - RNPGA - BSM - GHC - SJHC - SEAMO - WHA - CCM - FHG
When to Use
- Use Q111A when your rostered patient population achieves a 60% screening rate for mammography, provided you are in an eligible model like FHG or CCM.
- Submit this code once you have confirmed your roster's screening percentage meets the 60% threshold but falls below the higher tier requirements for Q112A.
Common Pitfalls
- Billing Q111A when your roster size does not meet the minimum requirements specified in the Appendix Q guidelines for your specific funding model.
- Attempting to bill Q111A alongside Q110A for the same patient or period, which can trigger reconciliation errors regarding the cumulative nature of these preventive bonuses.
Billing Tips
- Ensure your EMR preventive care dashboard is accurately mapped to the Ministry's roster data to avoid discrepancies between your internal tracking and the actual Q111A eligibility report.
Provider Fee$0.00
Effective: March 1, 2005
Category
AQ. Appendix Q
Subcategory
APPENDIX Q
Service Type
Other
Code Classes
Other Premiums (including After Hours Procedure Premiums)
The bonus amount for achieving the 60% target with this code is $440.
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