All codes
Q113A
Q113A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Mammography - 70%
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
The Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) for Mammography provides a bonus payment of $1320 for achieving a 70% screening rate. This service must be billed at $0.00 and is only eligible for RNPGA, BSM, GHC, SJHC, SEAMO, WHA, CCM and FHG physicians who meet the minimum roster size.
When to Use
- Use Q113A when your rostered patient population achieves the 70% screening threshold for mammography as defined by the Ministry of Health's Preventive Care Bonus program.
- Submit this code only after verifying your Preventive Care Bonus report confirms you have met the specific 70% target for the mammography indicator.
Common Pitfalls
- Billing Q113A when you have only reached the 50% or 60% thresholds, which are covered by different codes like Q112A, leading to automatic rejection.
- Attempting to bill this code if you are not part of an eligible model such as FHG, FHO, or other listed alternative payment programs, as the claim will be rejected for ineligible provider type.
Billing Tips
- Ensure the claim is submitted with a $0.00 fee, as this is a tracking code that triggers the automated bonus payment calculation based on your roster data.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.