All codes
Q646
Q646 – Q646
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q646 when submitting a claim for a patient who has been formally enrolled in your practice under the Primary Care Model (PCM) to trigger the appropriate capitation or shadow billing requirements.
- Apply this code when documenting the initial roster attachment for a patient to ensure they are correctly linked to your billing group for future incentive eligibility.
Common Pitfalls
- Billing Q646 for patients who are already rostered to another physician will result in a rejection, as a patient cannot be simultaneously enrolled in two primary care rosters.
- Failure to ensure the patient's health card is valid at the time of submission will lead to automatic rejection, as Q646 relies on active OHIP eligibility verification.
Billing Tips
- Always verify the patient's enrollment status via the Ministry's Patient Enrollment and Coverage Verification (PECV) system before submitting Q646 to avoid unnecessary administrative rejections.
Provider Fee$0.00
Effective: October 1, 2008
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