FHO+ Model Update (What’s Changed)
The new FHO+ model introduces time-based (hourly) billing to better reflect the full scope of family physician work.
Key updates:
Physicians can now bill for time spent, not just visits
New hourly codes cover:
Direct patient care
Indirect patient care (e.g. charting, labs)
Clinical administration
Telephone care outside the clinic
Billing is done in 15-minute increments
This is in addition to existing FHO payments (capitation and shadow billing)
Important: Patient Information Requirements
For FHO+ hourly codes:
Do NOT include:
Health card number
Version code
Date of birth
These codes must be submitted using a “dummy” patient profile
Please contact our team at hello@dr-bill.ca or via chat to assign this patient profile to you.
The 4 Codes You Need to Know
Q310 – Direct Care (In-Clinic or Video)
Use for any time you are directly with a rostered patient:
In-person visits
Video visits
Phone calls while in clinic
Teaching during a patient encounter
Think: Face-to-face care (or equivalent)
Q311 – Phone Care (Out of Office)
Use for:
Phone calls with rostered patients when you are not in clinic
Think: Calls done from home or outside the office
Note: Paid at a slightly reduced rate
Q312 – Indirect Care (Patient-Specific)
Use for work tied to a specific patient without direct interaction:
Charting and documentation
Reviewing labs, imaging, consult notes
Referrals and requisitions
Completing insured forms (including death certificates)
Care coordination
Speaking with family members or caregivers
Messaging patients (insured care)
Case discussions with other providers
Think: Behind-the-scenes patient work
Q313 – Clinical Administration (Non-Patient Specific)
Use for clinic-level work requiring physician expertise:
Preventive care and roster management (screening, chronic disease)
EMR updates requiring clinical judgment
Quality improvement initiatives
Clinic workflow or implementation work
Do not use for:
HR or staffing
Finance or billing admin
Supply ordering
Think: Managing your roster, not an individual patient
How to Bill
Bill in 15-minute increments
Group time into blocks (avoid billing small individual tasks)
Examples:
1 hour inbox work → Q312 (4 units)
30-minute visit → Q310 (2 units)
Dr.Bill Workflow
At the end of the day:
Total your time in each category:
Q310 (Direct)
Q311 (Phone)
Q312 (Indirect)
Q313 (Admin)
Submit one claim per category, not per task
What You Cannot Bill
Care for non-rostered patients
Uninsured services (e.g. notes, insurance forms, cosmetic services)
Work performed by nurses or other staff
Services outside the family practice setting (e.g. emergency department work)
Non-clinical clinic administration (HR, payroll, supplies)
Teaching Rules
You can bill when teaching if you are actively involved in patient care
You can bill indirect time when reviewing cases with learners
You cannot bill:
For care performed only by learners without supervision
More than once for multiple learners at the same time
Common Mistakes
Billing Q310 and a visit code for the same time
Logging very small tasks instead of batching time
Using Q313 for general administrative work
Billing for non-rostered patients
Quick Reference
Task | Code |
Patient visit | Q310 |
Video visit | Q310 |
Phone (in clinic) | Q310 |
Phone (out of clinic) | Q311 |
Charting | Q312 |
Reviewing labs/results | Q312 |
Referrals/forms | Q312 |
Inbox time | Q312 |
Panel management | Q313 |
Quality improvement / EMR work | Q313 |
Summary
Q310 = Direct patient care
Q311 = Phone care outside the clinic
Q312 = Patient-specific work without interaction
Q313 = Clinic-level physician work
In Dr.Bill: track time, group it into categories, and submit in blocks. Please note, our system and our agents will not track daily limits. This is a requirement on your end.
For more information, please refer to the OMA Website. If you have any questions, please let our team know at hello@dr-bill.ca.
Happy Billing!