Holiday Office Coverage for Family Physicians Q888/A888

The following is not an SGFP Chair’s Letter but a memo from OMA.

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Dear SGFP Members,

Holiday Office Coverage for Family Physicians, Q888, A888 and Q012/Q016

Provided that all the criteria for A888 (Q888 for FHO) have been met, this year, as both Christmas and New Year’s fall on a Thursday, A888 (Q888 for FHO) can be billed Dec. 25, 2025 to Jan. 1, 2026 inclusive in addition to all regular weekend and holidays.

For more information, please see the Schedule of Benefits page GP3.

After-hours services obligations for physicians in patient-enrollment models (CCM, FHG, FHN, FHO) are specified in the respective primary care contracts. During the holiday period, except for the recognized statutory holidays, physicians in patient enrollment models continue to be required to meet the service obligations.

Family Health Organization (FHO) physicians

As a reminder, the FHO contract requires that both scheduled and unscheduled appointments are to be made available during after-hours. The Q888 can be billed for rostered patients when at least 3 scheduled appointments have been offered. Please note the Q888 is not on the list of eligible fee codes that can be billed virtually.

During the Dec. 25 – Jan. 1 period, the Q888 (plus Q012) should be used for unscheduled rostered patients, the most appropriate fee code as per the Schedule of Benefits (plus Q012, if applicable) for scheduled rostered patients, and the most appropriate fee code as per the Schedule of Benefits for non-rostered patients. Keping in mind that after-hours blocks still must be done after 5 p.m. or before 8 a.m. as per the contract requirements, the timing of after-hours blocks cannot be shifted to daytime hours.

Where the minimum required weekend after-hours blocks have already been met by the group, and further after-hours clinics can be provided, the A888 can be billed if all other Schedule of Benefits requirements for that fee code are met.

Please see the OMA section dedicated to the Q888 (note you will need your OMA log-in and password to view the site).

All other physicians including FHN, FHG, CCM and FFS physicians

For those physicians in a FHN, FHG or CCM the Q888 is not an eligible code.

If the clinic is not scheduling appointments and operating as an emergency department equivalent, then the A888 can be billed with the Q012/Q016 added on for rostered patients.

If the clinic is scheduling appointments, then regular Schedule of Benefit codes apply.

Summary
A888: An emergency department equivalent - partial assessment is an assessment rendered in an emergency department equivalent on a Saturday, Sunday, or Holiday for the purpose of dealing with an emergency: $37.95

An “emergency department equivalent” is defined in the Schedule of Benefits as: an office or other place, including Urgent Care Centres, Walk-in Clinics, Extended Hours Clinics, or other settings (other than a hospital emergency department) in which the only insured services provided are to patients who do not have pre-arranged appointments.

To assist patients to find the appropriate care over the holidays, family physicians can provide patients with notification of hours of coverage and after-hours clinic locations.
Notifications can be done, for instance, through answering machine messages, clinic posters or on a practice website.

If you have any questions, please contact the Ontario Medical Association at info@oma.org.

Sincerely,

Kate Damberger
Director, OMA Economics, Research & Analytics