All codes
Q302
Q302 – Q302
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q302 for the initial assessment and management of a patient with a confirmed diagnosis of diabetes mellitus, provided the visit meets the comprehensive criteria.
- Apply this code when conducting the annual diabetes management review for patients who require a structured, multi-disciplinary approach to their chronic disease care.
- Select Q302 instead of a standard A007 when the encounter is specifically dedicated to diabetes education, medication titration, and long-term glycemic control planning.
Common Pitfalls
- Billing Q302 on the same day as a general A007 or A008 for the same patient will trigger an automatic rejection for duplicate service.
- Failure to document the specific diabetes-related parameters, such as HbA1c, foot exam, or retinal screening status, makes the claim vulnerable to recovery during a Ministry audit.
- Using Q302 for routine follow-ups that do not meet the comprehensive management requirements of the code definition is a frequent cause of audit adjustments.
Billing Tips
- Ensure your EMR template for Q302 includes a mandatory checklist for diabetes-specific indicators to satisfy the documentation requirements for this premium fee.
- If the patient requires additional acute care for a non-diabetes related issue during the same visit, bill the acute issue as a separate visit on a different day to avoid bundling conflicts.
Provider Fee$70.29
Effective: April 1, 2026
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