FHO+ Hourly Rate

FHO+ Hourly Rate

EMR Recommendations & Resources

Last Updated: March 27, 2026

Recording time-based activities in your EMR for FHO+ Hourly Rate

This site provides recommendations to help physicians document time-based FHO+ hourly rate activities with step-by-step EMR instructions and resources.

Effective April 1, 2026, a new hourly rate will compensate FHO physicians for time spent on direct and indirect patient care, as well as clinical administrative work.

FHO+ Hourly Rate guides for select EMRs available for download. Some guides were developed by OntarioMD, others are provided by EMR vendors to reflect workflows in their systems.

Reviewing your roster helps keep your patient panel accurate and up to date.  

Why this matters – Time-based activities apply only to care provided to FHO rostered patients. Maintaining an accurate roster helps distinguish care provided to rostered versus non-rostered patients.

When to do this – It is recommended that you review your roster monthly or quarterly. Using the provided roster reconciliation tools and processing the files regularly ensures updates are quick and manageable.

Helpful Tools – Use the Roster Reconciliation Tool, developed by Dr. Kevin Brophy and Dr. Alex Duong, to identify discrepancies and improve roster data quality. 

Tip: Some EMRs also include features to easily reconcile and update patient enrollment status and related data:

Know how your EMR displays rostered versus non-rostered patients. Indicators may be automatic or require manual action.

Indicators that may be available:

  • Roster or enrollment fields
  • Patient status labels or demographic bands
  • Custom flags, colours or attributes

Why this matters – Understanding how your EMR identifies roster status helps with identifying and tracking FHO+ hourly rate hours and activities only for eligible (rostered) patients.

When to do this – Complete this as a one-time review when setting up workflows. Revisit if EMR settings or clinic processes change.

Tip: Ensure staff understand how your roster status can be identified in your EMR (automatically or manually).

Helpful tools – Explore your EMR’s roster and enrollment indicators to understand how rostered patients are identified and displayed within charts, schedules, or demographic views, and check whether indicators are automated or require manual action.

Review how Accuro identifies rostered versus non‑rostered patients.  Staff can assist with these tasks. 

  • Patients Demographics: View a patient’s enrollment status in the Provider Enrollment History tab.
Screenshot of Accuro EMR patient demographics showing provider enrollment history for a patient. The highlighted section displays the Provider Enrollment History tab and enrollment status as "Enrolled".
  • Global Patient: Add the enrollment status to the patient’s demographic status bar at the Global level for ongoing visibility when working with that patient.
Screenshot of a User Preferences, Display settings from Accuro EMR. Key elements include enrollment status in the Status Bar Line 2, highlighted as "Enrolled" in a red box.

For step-by-step instructions, download the FHO+ Hourly Rate Accuro guide.

Review how Oscar Pro identifies rostered versus non‑rostered patients. Staff can assist with these tasks.

  • Patient Master Record: View a patient’s enrollment status in the Clinic Status (Enrollment History) section.
Screenshot of a User Preferences, Display settings from Accuro EMR. Key elements include enrollment status in the Status Bar Line 2, highlighted as "Enrolled" in a red box.
  • eChart: View a patient’s enrollment status at the top of your eChart.
Screenshot of a OSCAR Pro EMR displaying patient information. Key elements include enrollment status highlighted as "RO" in a red box.

For step-by-step instructions, download the FHO+ Hourly Rate OSCAR PRO guide.

Review how TELUS PSS identifies rostered versus non‑rostered patients.  Staff can assist with these tasks.

  • Demographics window: View a patient’s enrollment status in the Patients window.
Screenshot of a member status section from Patient demographics in TELUS PSS EMR. It highlights member status as "FHO Enrolled,".
  • Records window: Enrollment status is displayed at the top in the demographic band.
Screenshot of a patient enrollment record in TELUS PSS EMR. Key data includes member status as "FHO Enrolled,".

For step-by-step instructions, download the FHO+ Hourly Rate TELUS PSS guide.

Consider flagging non-rostered patient appointments in your schedule to assist with end-of-day calculations for Direct Patient Care and identify visits that are eligible for hourly rate billing.

Why this matters – Flagging non-rostered patient appointments helps ensure you calculate Direct Patient Care hours only for eligible (rostered) patients and separate time spent with non-rostered patients.

When to do this – This can be completed during appointment booking or when reviewing scheduled appointments in the schedule. Staff can assist by identifying and flagging non-rostered patient appointments.

Helpful tools – Flag non-rostered patient appointments in your schedule using EMR features like labels, icons, schedule notes or colour coding to easily distinguish them from rostered visits.

Tip: There are multiple ways to flag appointments – your EMR may offer additional options. Choose the method that works best  for your practice.

Creating and assigning statuses to flag non-rostered patient appointments displays them on the Day Sheet and Schedule to help physicians quickly recognize rostered patient visits eligible for hourly rate billing.

Screenshot of Accuro EMR scheduling software showing a appointment for a patient. Appointment details include a status indicator for non-rostered and screening complete.

For step-by-step instructions, download the FHO+ Hourly Rate Accuro guide.

You can enable a setting that allows patient enrollment status to display on the schedule to help physicians quickly recognize rostered patient visits eligible for hourly rate billing.

Screenshot of a OSCAR Pro schedule showing an appointment. Key element is a note indicating "(RO: Dr. oscardoc, doctor)" in a red-bordered box.

For step-by-step instructions, download the FHO+ Hourly Rate OSCAR PRO guide.

Using colour coding in the schedule to identify non-rostered patient appointments can help physicians quickly recognize rostered patient visits eligible for hourly rate billing.

Screenshot of a TELUS PSS EMR schedule showing appointments. Key element is one appointment has a brown background compared to the white background in others to indicate non-rostered patient.

For step-by-step instructions, download the FHO+ Hourly Rate TELUS PSS guide.

Consider categorizing appointments by FHO+ care types in your schedule to easily delineate:

  • Direct Care: In-person & Virtual
  • Direct Care: Phone Out-of-Office
  • Indirect Care
  • Clinical Administration

Why this matters – Categorizing appointments helps ensure accurate tracking of FHO+ hourly rate care categories and allows you to quickly identify the type of care provided.

When to do this – Categories can be applied when booking appointments, when reviewing scheduled appointments, or when recording additional unscheduled care such as Indirect or Clinical Administration.

Helpful Tools – Use EMR features like labels, icons, schedule notes, appointment types or colour coding to categorize care types. Consistently naming, colour coding or visually flagging care categories (e.g. “Direct Care: In-person/Virtual,” “Direct Care: Phone Out-of-Office,” “Indirect Care,” “Clinical Admin”) makes it easier to track and report hours.

Tip: There are multiple ways to categorize appointments – your EMR may have additional options. Choose the method that works best for your practice.

Creating and assigning category statuses to appointments for FHO+ hourly rate care types displays them on the Day Sheet and Schedule, helping physicians quickly differentiate the care provided.

Screenshot of a Scheduler Management in Accuro EMR displaying the tab for Priorities, Reasons and Statuses. Statuses section shows various status labels with abbreviations, icons, and colors, including a highlighted "Indirect care" status with abbreviation "IC" and an orange circle icon.

For step-by-step instructions, download the FHO+ Hourly Rate Accuro guide.

Creating an appointment type and assigning appointment details allows you to categorize appointments for different FHO+ hourly rate care activities. These details display on the Schedule, helping physicians quickly identify the type of care being provided.

Screenshot of OSCAR Pro appointment showing a highlighted label with red border containing text "FHO+ Indirect Care (Appt Type) | FHO+ Indirect Care (Appt Reason)".

For step-by-step instructions, download the FHO+ Hourly Rate OSCAR PRO guide.

Icons can be used within the schedule to visually identify time that was spent performing Indirect Care or Clinical Administration activities.

  • Select an icon that is easily recognizable and clearly distinguishable from those used for clinical appointments.
  • Keep in mind that there is a limited set of preselected icons available within the EMR. Choose thoughtfully to avoid overlap or confusion with existing workflows.
  • Once implemented, ensure all staff are informed of the icon’s purpose and consistent use to maintain clarity across the schedule.
Screenshot of the TELUS PSS appointment‑booking window showing scheduling details. A dropdown menu is open, and the “FHO+ Indirect Care” option is selected and highlighted in blue to indicate the appointment type.

For step-by-step instructions, download the FHO+ Hourly Rate TELUS PSS guide.

Create a designated “tracking” patient in your EMR to document your daily hours and activities. In some EMRs, it can also be used to submit FHO+ hourly rate billing. This “tracking patient” contains no real patient information and may be set up by staff.

Why this matters

  • Establishes a consistent place to document your daily hours and activities.
  • Allows you to follow a familiar workflow: open chart → create note → document.
  • Keeps all documentation EMR-first and audit ready.

When to do this – Set up this tracking patient once at the start as part of preparing your FHO+ hourly rate documentation workflow. After setup, this tracking patient will be used every day to record your hours and activities.

Revisit if EMR settings, clinic workflows, or staff responsibilities change.

For example:

  • A new physician begins using the same EMR.
  • EMR updates affect the tracking patient, charting or template functionality.
  • Clinic workflows change how daily tracking or billing is performed.

Helpful Tools

  • Create one tracking patient per clinician who will be documenting and billing FHO+ hourly rate.
  • Name the tracking patient clearly and meaningfully (e.g. “Smith – FHO+ Hourly Rate”).
  • If multiple physicians share one EMR, include the physician’s name or initials in the tracking patient’s name to keep charts separate.
  • This tracking patient may later be used to submit the hourly rate billing claims where supported. Refer to your FHO+ Hourly Rate EMR guide for details (linked below).
Screenshot of a software interface showing a patient information form with fields for surname and first name. The surname is entered as "Smith" and the first name as "Hourly Rate," highlighted by a red box.

For step-by-step instructions, download your FHO+ Hourly Rate EMR guide.

Schedule a recurring end‑of‑day appointment for the designated tracking patient (see Create a Designated “Tracking” Patient ). This serves as a reminder to calculate and document your daily FHO+ hourly rate time-based activities and hours. Staff can assist with setting up this recurring appointment.

Why this matters

  • Acts as a reminder to integrate time tracking and documentation into the daily workflow.
  • Reduces the risk of missed or forgotten hours.
  • Encourages adherence to consistently track FHO+ hourly rate time and activities.
  • Allocates flexible time in the EMR schedule for end-of-day documentation.

When to do this

  • Set up the recurring appointment at the start of the month, or as early as possible, to avoid conflicts.
  • Schedule the appointment at the end of the day, after the last booked patient, to avoid double-booking or interference with regularly scheduled appointments.
  • Booking the appointment for every day of the month can help capture all eligible hours, since work may occur on any day.
  • Consider colour coding or flagging the appointment to make it easily identifiable in the schedule.

Helpful Tools

  • Note: If your EMR does not allow booking a tracking patient, consider creating an end of day prompt instead.
  • If you record and submit Online Appointment Booking (OAB) metrics, be sure to subtract the recurring appointment(s) from your totals (1 x the number of days in the month the tracking patient appointment is added).

Recurring appointments are created in the Scheduler: Using your designated tracking patient, create a new appointment on the first day of the month at the end of the scheduled day.

For step-by-step instructions, download the FHO+ Hourly Rate Accuro guide.

  • In the scheduler, create an appointment for your tracking patient
  • Use the R button in the bottom-right to set it as a recurring appointment

For step-by-step instructions, download the FHO+ Hourly Rate OSCAR PRO guide.

  • In the Appointment window
  • Double-click the desired time slot for the appointment
  • Choose the patient and appointment details
  • Select Repeat to create repeat appointments

For step-by-step instructions, download the FHO+ Hourly Rate TELUS PSS guide.

Each day, use the provided structured encounter note template for your tracking patient to record your daily FHO+ hourly-rate time and activities for the work performed that day. This ensures that time spent on each eligible category is documented consistently and that supporting details are available if requested for audit purposes.

Why this matters

  • Ensures accurate documentation of actual time spent on Direct Care, Direct Phone Care, Indirect Care and Clinical Administration.
  • Demonstrates the work performed for claimed Indirect and Clinical Administration hours if requested by the Ministry of Health (MOH).
  • EMR audit and security reports may not provide a full picture of daily activities.  Using the daily note template ensures a complete record, including work performed outside the EMR.

When to do this

  • Physicians are required to enter a daily record each day for the work performed (including time spent and activities, as applicable).
  • The hourly rate is billed in 15-minute units, calculated cumulatively across the day.Note: Any remainder of eight (8) minutes or more is rounded up to a full 15-minute unit.
  • Start and stop times do not need to be recorded for activities.
  • Activities do not need to be recorded on a patient-by-patient basis.
  • Refer to the OMA FHO+ hourly rate reference guide for more information.

Helpful tools

  • Use a consistent tool to speed up documentation like a template, stamp, or macro.
  • Using the same method each day improves clarity, consistency and efficiency.

Adding a Note in the Patient Chart

It is recommended to create a customized Note template that can be used in the tracking patient encounter notes to document daily hours and activities. Use the provided Note template or create one to match your workflow. Note: templates are stored in your Electronic Drawer for easy access.

When inserting a template or note, include or remove additional details as needed to match your workflow and accurately reflect the FHO+ hourly rate activities completed that day.

Screenshot of Accuro EMR displaying a patient's Encounter Notes. Key element showing the Electronic Drawer in a red-bordered box.

Tip: Mark any note in your Electronic Drawer as a favourite to have it appear in the Favourites section at the top of the drawer. This makes it easy to quickly access your frequently used notes without searching through the full list.

For step-by-step instructions and note template, download the FHO+ Hourly Rate Accuro guide.

Note: The Accuro FHO+ Hourly Rate download includes a sample template.

Adding a Note in the Patient Chart

You can enter free text directly into the tracking patient chart or use a template to document your daily hours and activities.

When inserting a template or note, include additional details as needed to match your workflow and accurately reflect the FHO+ hourly rate activities completed that day.

Screenshot of OSCAR Pro search bar with a highlighted search field showing "FHO+" and a selected option labeled "FHO+ Hourly Rate" in a red box.

For step-by-step instructions and template, download the FHO+ Hourly Rate OSCAR PRO guide.

Note: The OSCAR Pro FHO+ Hourly Rate download includes a sample template.

Adding a Note in the Patient Chart

You can enter free text directly in the tracking patient chart or use a stamp to document your daily hours and activities.

  • You can enter free text directly in the tracking patient chart or use a stamp to document your daily hours and activities.
  • Stamps can be inserted into patient charts by typing the name of the stamp and pressing Ctrl+I, OR by selecting Settings > Edit Stamps… > Insert Stamp.

When inserting a stamp or note, include or remove additional details as needed to match your workflow and accurately reflect the FHO+ hourly rate activities completed that day.

Screenshot of TELUS PSS Records window. The screen shows a recommended stamp for tracking daily hours and activities.

For step-by-step instructions and stamp, download the FHO+ Hourly Rate TELUS PSS guide.

Note: The TELUS PSS FHO+ Hourly Rate download includes a sample stamp.

The new FHO+ hourly rate billing codes may need to be added manually to your EMR, as they are not part of the OHIP schedule of benefits and may not be included in automatic vendor updates. Instructions for adding these codes are available in the FHO+ Hourly Rate EMR Guides provided on this site. You may also contact your vendor for assistance.

Tip: Billing for the hourly rate is handled similarly to CME or the preventive care annual bonus.

Why this matters – Adding the codes will allow physicians to accurately record and submit FHO+ hourly rate claims. Ensuring the codes are in place helps maintain smooth billing workflows and supports consistent tracking of eligible hours.

When to do this – Add the billing codes to your EMR before April 1, 2026, so they are available when you begin recording FHO+ hourly rate activities.

Helpful tools

Considerations for FHO+ hourly rate billing claims (further instructions in FHO+ Hourly Rate EMR Guides)

  • Submitted claims must not contain a health number, version code or birthdate – Refer to your EMR guide for billing codes submitted without patient identifiers (no patient attached or demographics removed), or the FHO+ Hourly Rate EMR Guides
  • Billing codes are submitted at the fee per unit and paid based on the number of units billed
  • Adjust the units or quantity to reflect claimed hours (1 unit = 15 minutes)
  • Daily claims cannot exceed 14 hours
  • Service codes do not require an associated diagnosis code

Note: Final FHO+ Hourly Rate billing details will be confirmed in the upcoming Ministry of Health Information Bulletin

Table displaying categories of healthcare activities with corresponding codes and examples from a guide. It includes four categories: Direct care in-person or video (Q310), Direct phone out-of-office (Q311), Indirect patient care (Q312), and Clinical administration time (Q313), each with specific descriptions of tasks involved.

Use your EMR’s built‑in functions to streamline billing entry and validate claims.

  • Create a billing shortcut – Depending on your EMR, group FHO+ hourly rate codes you regularly bill in a shortcut and adjust the time units to reflect hours worked
  • Check defaults – EMRs may automatically assign a minimum of 1 unit or quantity for each code. Delete any codes not applicable to that date of service
  • Verify claims – Some EMRs provide reports for unbilled appointments. Regularly use these reports or other clinic-approved billing checks/reports to ensure claims have been created and submitted

Need billing support? Contact the OMA at info@oma.org – your primary source of support.

Add the billing codes to Accuro

  • Go to Menu > Billing > Billing Options > Manage Procedure Codes
Screenshot of Accuro EMR menu showing navigation options for billing-related tasks. The menu includes the section Billing expanded to display the option Manage Procedure Codes highlighted.

For step-by-step instructions, download the FHO+ Hourly Rate Accuro guide.

Add the billing codes to OSCAR PRO

  • Go to Administration → Billing → Manage Billing Service Code
Screenshot of OSCAR PRO manage billing service code panel showing fields for entering service code. Key details include a service code "Q310," description "Direct Patient Care - In-Person or Virtual," fee set to "0.00," issued date "2026-04-01," and a save button.

For step-by-step instructions, download the FHO+ Hourly Rate OSCAR PRO guide.

Add the billing codes to TELUS PSS:

  • Go to Window → Fees
  • To add a new fee, select Edit → Add Record
Screenshot of TELUS PSS Fee window showing details for fee code Q310A labeled "Direct Care In Person or Virtual." The window includes columns for old and new fees, checkboxes for billing conditions and usage settings, with most fees set to 0.00 and the "Allowed on MoH No Patient Bills" option checked.

For step-by-step instructions, download the FHO+ Hourly Rate TELUS PSS guide.

Track your daily hours to stay within allowable daily and monthly billing limits. This helps you keep an accurate record, monitor your hours, and avoid rejected claims. The FHO+ Hourly Rate Calculator automates calculations and supports ongoing tracking and monitoring of your daily entries. Physicians may use the FHO+ Hourly Rate Calculator or other preferred tracking tools to ensure alignment with billing limits.

Why this matters

  • Physicians must adhere to billing limits to avoid claim rejections or overpayments
  • The OHIP system will reject claims that exceed the 14-hour daily limit or the prorated monthly limit of 240 hours. Physicians are responsible for staying within the percentage caps:
    • 25 per cent of your total billable hours monthly can be for indirect care and clinical administration (together)
    • Five per cent of your total direct and indirect care hours monthly can be for clinical administration
  • As of April 1, 2026, only absolute hour caps (14/day, 240/month) will be in place. The Ministry of Health will reject billings over these amounts.
  • As of April 1, 2026, the percentages caps will NOT be in place. If a physician submits hours exceeding these caps, payment for the extra hours will be adjusted at a future date (to be determined)

When to do this

  • Daily, weekly or as convenient, enter the daily hours from the EMR tracking patient (documented daily) into the FHO+ Hourly Rate Calculator, with each day entered separately
  • Work month-by-month in the FHO+ Hourly Rate Calculator and clear data between monthly periods to avoid confusion
  • Staff can assist with transposing hours from the EMR into the calculator as needed.
  • The calculator is optional and is meant only to complement the required daily documentation (maintained in the EMR as recommended). Physicians can use it to monitor ongoing totals and alignment with billing limits by transposing cumulative hours from the EMR.

Important: The FHO+ Hourly Rate Calculator is a supplementary tool and does not replace EMR documentation nor capture FHO+ hourly rate care category activities for audit purposes.

Helpful tools – Download the FHO+ Hourly Rate Calculator

Download the FHO+ Hourly Rate EMR Guide for your system

Some guides were developed by OntarioMD, others are provided by EMR vendors to reflect workflows in their systems.

AVAROS How to Bill FHO+ Guide (provided by AVAROS EMR)

Download the FHO+ Hourly Rate Calculator

Current Version: v8.6.4 (2026-03-27)

This tool was developed through iterative collaboration, with valuable feedback and contributions from the OMA, OMD, OntarioMD Peer Leaders, Dr. Anushiya Ganeshalingam, Dr. Ryan Banach, Dr. Salesh Budhoo, Dr. Kevin Brophy, Dr. Adam Stewart, Dr. Ross Male, and Dr. Reena Dhatt.

Need billing support? Contact the OMA at info@oma.org – your primary source of support.

Visit the OMA FHO+: Frequently asked questions page for more information.