All codes
Q301
Q301 – Q301
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q301 for the initial comprehensive assessment of a patient with a confirmed diagnosis of diabetes mellitus, including the development of a formal management plan.
- Apply this code when performing an annual review for a diabetic patient that involves a detailed physical examination, laboratory review, and adjustment of the long-term care strategy.
Common Pitfalls
- Billing Q301 in conjunction with a standard A007 or A001 assessment on the same day is prohibited as it is considered an inclusive service.
- Submitting Q301 more than once per patient per 12-month period will trigger an automatic rejection from the Ministry.
- Failing to document the specific components of the diabetes management plan in the chart will lead to clawbacks during a post-payment audit.
Billing Tips
- Ensure the diagnosis code for diabetes is explicitly linked to the Q301 claim to avoid rejection for lack of medical necessity.
- If the visit involves significant counseling beyond the scope of the management plan, consider whether a time-based counseling code is more appropriate, but remember that Q301 cannot be billed with other assessment codes on the same date.
Provider Fee$64.71
Effective: April 1, 2026
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