How to Bill FHO+ Hourly Rate Codes

Source: https://www.ontario.ca/document/ohip-infobulletins-2026/bulletin-260309-2024-physician-services-agreement-fho-hourly-rate#section-1

Summary & A Download Link To Our FHO+ Calculator

This article explains what the four FHO+ hourly-rate codes mean, how to track the time, how to calculate the number of services and what limits to watch. The goal is to make daily billing simple and easy to review later.  Download your excel FHO+ calculator here.

Which hourly-rate codes do I use?

Q310 — Direct Patient Care (In Person or Video)

Use Q310 for time you personally spend caring for rostered patients in person or by video.
Rate: $80/hour = $20 per 15 minutes. (oma.org)

Q311 — Direct Telephone Care (Out of Office)

Use Q311 for telephone care you personally provide to rostered patients when you are out of the office.
Rate: $68/hour = $17 per 15 minutes. (oma.org)

Q312 — Indirect Patient Care

Use Q312 for patient-related work with no direct patient contact, such as:

• reviewing labs or imaging

• charting

• referrals

• care coordination

• reviewing consult notes

Rate: $80/hour = $20 per 15 minutes. (oma.org)

Q313 — Clinical Administration - Indirect

Use Q313 for non-patient-specific clinical work for your roster or panel, such as:

• screening follow-up work

• chronic disease planning

• EMR clean-up needing physician judgment

• quality improvement work

Rate: $80/hour = $20 per 15 minutes. (oma.org)

What do I still bill normally?

You still bill your usual billing codes as normal. The hourly-rate codes are billed on top of your normal shadow billing. The hourly-rate codes are billed as a cumulative total on the usual claim form without patient demographics.

How do I track the time?

The concept is to keep a simple daily log with totals for each code.

For example:

For Q312 and Q313, keep a short note describing the work done. Start and stop times are not required for these hourly-rate codes. (oma.org)

What are the limits?

Daily limit

Maximum 14 hours per day. (oma.org)

Monthly limit

Maximum 240 hours per 28 days, prorated by month:

• 28 days: 240 hours

• 29 days: 248.6 hours

• 30 days: 257.1 hours

• 31 days: 265.7 hours 

Q312 + Q313 combined limit

Indirect care plus clinical administration can be no more than 25% of total billable hours over the monthly period. 

Q313 limit

Clinical administration alone can be no more than 5% of direct + indirect care hours over the monthly period.

What should I not include?

Do not use these codes for:

• non-rostered patients

• staff time

• uninsured work

• hospitalist work

• emergency department work

• obstetrical in-hospital work

• anesthesia or surgical assist work

• general business administration like HR, payroll, or bookkeeping

Best practice

The easiest daily method is:

1. Bill as usual.

2. Keep a simple daily hourly log.

3. Enter one daily total per Q-code.
   

4. Track the time spent directly on patients with the direct FHO+ Hourly Rate Code Q310 and Q311.

5. Keep short general notes for time spent Indirectly on patients and related admin work with Q312 and Q313.

6. Review daily and monthly limits before submission. 
   

See the attached daily FHO+ Hourly Rate Codes worksheet. Use it, modify it and comment on it. How can we improve on it? Should there be a variety of it?