Billing Guide, On-Call, and Vaccine Billing Tips
Billing Guide, On-Call, and Vaccine Billing Tips
Dear SGFP Members,
A couple of quick notes from me before I pass the pen to our SGFP Tariff Lead, Dr. Salesh Budhoo. He has a timely update on FHO billing for flu, COVID-19 and RSV vaccines.
Updated SGFP Billing Guide: New Link
A few weeks ago, we shared a link to the April 2026 SGFP Billing Guide. Several of you told us the print contrast made it hard to read, so we revised it. Thank you for flagging it. The revised version is at a new link on our website, so please update any bookmarks: SGFP Billing Guide.
SGFP On-Call: Final Round of 2026 Now Open for Booking
Our final 2026 round of SGFP On-Call sessions is now open. These 20-minute, 1:1 conversations with SGFP leaders are one of the most valuable ways we hear what’s happening in your practice, and your input drives our work. Book your spot here.
And now, over to Salesh.
Warm Regards,
Dr. Dave Barber, Chair, SGFP
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Dr. Salesh Budhoo, SGFP Tariff Lead
Flu, COVID & RSV Vaccine Billing Reminder (FHO)
Dear Colleagues,
Vaccine season is ramping up, and a few of you have told us immunization billing under FHO has been unclear. Here’s a quick refresher.
Flu shot: rostered patients
- Sole reason for visit: G590 ($8.80) + Q590A premium ($8.80). For patients 65 and older, add the Q130A tracking code.
- With an assessment: G590 + assessment code. For patients 65 and older, add Q130A. Do not bill Q590A.
Flu shot: non-rostered patients
- Sole reason for visit: G590 ($8.80) + G700 ($8.80).
- With an assessment: G590 only. The flu assessment is included in G590. An assessment fee is payable only if the assessment was for a separate issue.
COVID-19 vaccine: all patients
- G593 ($13.00): outside the basket.
- Q593 ($8.80): outside the basket. Bill it instead of G700 when the COVID vaccine is the sole reason for the visit. It is payable for both rostered and non-rostered patients.
RSV vaccine or monoclonal antibody
- G849 ($8.80): in basket for FHO/FHN. It includes routine immunization counselling. It must be given by the physician or by a delegate who meets the delegated-procedure billing criteria.
- Sole reason for visit: G849 + G700. G700 is paid at only 15% for patients enrolled in a capitation-based group.
- Given with another vaccine: bill G849 plus the other vaccine’s codes.
Key rules
- Premiums are for sole-purpose visits only. If you billed an assessment, don’t add Q590A, Q593 or G700.
- One premium per visit. Q590A and Q593 can’t both be billed for the same patient on the same day. For a combined flu and COVID visit, bill G590 + G593 with only one premium.
- Once per year. Only one of Q590A or Q593 can be billed per patient per year.
- G700 exclusions. G700 is not payable in hospital. It is also not payable when the same physician bills an assessment that day.
Warm regards,
Dr. Salesh Budhoo, SGFP Tariff Lead
Other Resources
How can we support the public to self-manage minor health concerns?
Family physicians, emergency physicians, and other health professionals in Ontario are invited to participate in a brief survey on minor ailment self-management. We're seeking input on priority conditions where the public could benefit from evidence-based self-management resources, as well as your perspectives on existing tools and what makes a resource trustworthy and useful. Findings will directly inform the development of new, publicly accessible self-management resources for people in Ontario.
The survey takes approximately 10 minutes to complete. Participation is voluntary, and all responses are anonymous.
This work is part of a multi-methods research study led by Drs. Tara Kiran and Archna Gupta at the MAP Centre for Urban Health Solutions, St. Michael’s Hospital.
Take the survey: redcap.link/minorhealthconcerns
Talk on Grief
All Ontario physicians are invited to the District 11 annual Remembrance Day commemoration, where we will be exploring the concept of prolonged grief with one of the world's leading experts on the subject
Link to register: https://www.eventbrite.ca/e/doctors-lounge-tickets-2003220261728?aff=oddtdtcreator&sfmc_id=7557579
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