At a glance
Q310A, Q311A, Q312A and Q313A are billed in 15-minute units accumulated by category across each calendar day. A remainder of eight minutes or more rounds to another unit. Base values are $20 per unit for Q310A, Q312A and Q313A, and $17 per unit for Q311A. The Ministry’s May 2026 processing update says hourly claims billed at $0 reject.
Interactive tool
Estimate your Q310–Q313 billing.
Enter your eligible daily minutes by category to calculate units and estimated billing amounts. Confirm eligibility and current rules before submitting claims.
What each code represents
Direct Patient Care — In-Person or Video
Time personally spent providing eligible direct clinical services to enrolled patients. Ministry guidance includes in-person care, defined in-office telephone or video care, out-of-office video care and clinical teaching concurrent with patient care.
Ask:Was the physician directly providing the eligible service, and does Q311A not apply?
Direct Telephone-based Patient Care — Not in Office
Eligible telephone-based virtual care personally provided to enrolled patients when the physician is not physically present in the usual family-medicine practice setting.
Ask:Was this telephone—not video—and was the physician outside the usual office setting?
Indirect Patient Care
Eligible patient-specific work without direct contact. Ministry examples include charting, reviewing results or reports, preparing referrals, care coordination and certain clinically required forms.
Ask:Can the time be connected to an eligible insured service for a specific enrolled patient?
Clinical Administration Time
Qualifying non-patient-specific work requiring physician expertise for management of the roster or enrolled population, such as defined proactive panel management, physician-level EMR management and quality-improvement implementation.
Ask:Is this clinical population-management work, rather than HR, finance, supplies, leasing or other general business administration?
How daily minutes become units
- Record the actual work date.The claim’s service date must be the date the hourly activity occurred.
- Separate time by category.Do not combine Q310A minutes with Q312A minutes before rounding.
- Total each category for that calendar day.The calculation is cumulative across the day, not encounter by encounter.
- Divide by 15.After full units, a remainder of eight minutes or more rounds up; seven or fewer does not.
- Apply the correct dollar value.Multiply the final units by $20 or $17 as applicable, then apply current submission requirements.
Illustrative calculation
47 minutes of Q312A activity in one day
47 ÷ 15 = 3 full units with 2 minutes remaining. The result is 3 units. At the $20 base value, the submitted fee amount is $60, subject to current Ministry processing rules and applicable relativity.
This arithmetic example does not determine whether the underlying activities are eligible.
Limits your workflow should check
- Combined daily maximum: the Ministry and OMA identify a maximum of 14 hours, or 56 units, across the hourly categories in one day.
- Combined monthly maximum: the maximum is prorated by the number of days in the billing month; the Ministry lists 960 units for 28 days, 995 for 29, 1,029 for 30 and 1,063 for 31.
- Q312A plus Q313A: no more than 25% of total monthly hourly time can be indirect care and clinical administration.
- Q313A: clinical-administration time has an additional 5% limit relative to total Q310A, Q311A and Q312A hours.
Limits are a calculation control, not an eligibility test. A workflow should evaluate both.
Common process mistakes
Rounding each task
The published method accumulates minutes by category across the calendar day before rounding.
Using a convenient month-end date
The service date must reflect the actual date the activity occurred.
Submitting a zero-dollar fee
Ministry Bulletin 260501 says this rejects for applicable service dates; use the fee value for the units claimed.
Mixing Q312A and Q313A
Patient-specific indirect work and population-level clinical administration require different classification and limits.
Use the documentation checklist to review the supporting record behind these calculations.
Official sources
Rules and processing instructions can change. Confirm current requirements before submitting claims.
- Ontario Ministry of Health INFOBulletin 260308: FHO+ implementations for April 2026
- Ontario Ministry of Health INFOBulletin 260309: FHO hourly-rate payments
- Ontario Ministry of Health INFOBulletin 260501: hourly-rate payment processing update
- Ontario Medical Association FHO+ resource centre
- Ontario Medical Association FHO+ hourly-rate guide